Barriers and facilitators of medication reconciliation processes for recently discharged patients from community pharmacists' perspectives

Korey A Kennelty; Betty Chewning; Meg Wise; Amy Kind; Tonya Roberts; David Kreling

doi:10.1016/j.sapharm.2014.10.008

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Barriers and facilitators of medication reconciliation processes for recently discharged patients from community pharmacists' perspectives

Journal article

Peer reviewed

Barriers and facilitators of medication reconciliation processes for recently discharged patients from community pharmacists' perspectives

Korey A Kennelty, Betty Chewning, Meg Wise, Amy Kind, Tonya Roberts and David Kreling

Research in social and administrative pharmacy, Vol.11(4), pp.517-530

07/2015

DOI: 10.1016/j.sapharm.2014.10.008

PMCID: PMC4409924

PMID: 25586885

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Abstract

Community pharmacists play a vital part in reconciling medications for patients transitioning from hospital to community care, yet their roles have not been fully examined in the extant literature. The objectives of this study were to: 1) examine the barriers and facilitators community pharmacists face when reconciling medications for recently discharged patients; and 2) identify pharmacists' preferred content and modes of information transfer regarding updated medication information for recently discharged patients. Community pharmacists were purposively and conveniently sampled from the Wisconsin (U.S. state) pharmacist-based research network, Pharmacy Practice Enhancement and Action Research Link (PEARL Rx). Community pharmacists were interviewed face-to-face, and transcriptions from audio recordings were analyzed using directed content analysis. The Theory of Planned Behavior (TPB) guided the development of questions for the semi-structured interviews. Interviewed community pharmacists (N = 10) described the medication reconciliation process to be difficult and time-consuming for recently discharged patients. In the context of the TPB, more barriers than facilitators of reconciling medications were revealed. Themes were categorized as organizational and individual-level themes. Major organizational-level factors affecting the medication reconciliation process included: pharmacy resources, discharge communication, and hospital resources. Major individual-level factors affecting the medication reconciliation process included: pharmacists' perceived responsibility, relationships, patient perception of pharmacist, and patient characteristics. Interviewed pharmacists consistently responded that several pieces of information items would be helpful when reconciling medications for recently discharged patients, including the hospital medication discharge list and stop-orders for discontinued medications. The TPB was useful for identifying barriers and facilitators of medication reconciliation for recently discharged patients from community pharmacists' perspectives. The elucidation of these specific facilitators and barriers suggest promising avenues for future research interventions to improve exchange of medication information between the community pharmacy, hospitals, and patients.

Qualitative methods

Medication reconciliation

Transitions of care

Community pharmacy

Details

Title: Subtitle: Barriers and facilitators of medication reconciliation processes for recently discharged patients from community pharmacists' perspectives
Creators: Korey A Kennelty - Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
Betty Chewning - University of Wisconsin–Madison, School of Pharmacy, Sonderegger Research Center, Madison, WI, USA
Meg Wise - University of Wisconsin–Madison, School of Pharmacy, Sonderegger Research Center, Madison, WI, USA
Amy Kind - Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
Tonya Roberts - Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
David Kreling - University of Wisconsin–Madison, School of Pharmacy, Sonderegger Research Center, Madison, WI, USA
Resource Type: Journal article
Publication Details: Research in social and administrative pharmacy, Vol.11(4), pp.517-530
DOI: 10.1016/j.sapharm.2014.10.008
PMID: 25586885
PMCID: PMC4409924
NLM abbreviation: Res Social Adm Pharm
ISSN: 1551-7411
eISSN: 1934-8150
Publisher: Elsevier Inc
Grant note: DOI: 10.13039/100000002, name: National Institutes of Health, award: 1R36HS021984-01; name: UW- Madison School of Pharmacy Sonderegger Research Center; DOI: 10.13039/100006108, name: NIH National Center for Advancing Translational Sciences (NCATS), award: UL1TR000427; DOI: 10.13039/100000049, name: National Institute on Aging, award: K23AG034551; DOI: 10.13039/100000965, name: The American Federation for Aging Research; DOI: 10.13039/100000909, name: The John A. Hartford Foundation; DOI: 10.13039/100004426, name: The Atlantic Philanthropies; DOI: 10.13039/100009784, name: The Starr Foundation; name: National Center for Research Resources, National Institutes of Health, award: 1UL1RR025011
Language: English
Date published: 07/2015
Academic Unit: Family and Community Medicine; Pharmacy Practice and Science; Injury Prevention Research Center
Record Identifier: 9984065315302771

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