Problems in continuity of medication management upon transition between primary and secondary care: patients' and professionals' experiences

被引:15
|
作者
Foulon, Veerle [1 ]
Wuyts, Joke [1 ]
Desplenter, Franciska [2 ]
Spinewine, Anne [3 ]
Lacour, Valerie [3 ]
Paulus, Dominique [4 ]
De Lepeleire, Jan [5 ]
机构
[1] Katholieke Univ Leuven, Dept Pharmaceut & Pharmacol Sci, Clin Pharmacol & Pharmacotherapy, Leuven, Belgium
[2] Katholieke Univ Leuven, Z Org KU Leuven, Univ Psychiat Ctr, Kortenberg, Belgium
[3] Catholic Univ Louvain, Louvain Drug Res Inst, Fac Pharm & Sci Biomed, Brussels, Belgium
[4] Belgian Hlth Care Knowledge Ctr, Brussels, Belgium
[5] Katholieke Univ Leuven, Acad Ctr Gen Practice, Dept Publ Hlth & Primary Care, Leuven, Belgium
关键词
Seamless care; medication management; healthcare professionals; admission; discharge; DRUG-RELATED PROBLEMS; PATIENTS AFTER-DISCHARGE; COMMUNITY PHARMACISTS; ADVERSE EVENTS; RECONCILIATION; HISTORY; SAFETY; DISCREPANCIES; INFORMATION; PHYSICIAN;
D O I
10.1080/17843286.2018.1483561
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background and objectives Patients often experience drug-related problems at admission or after discharge from hospital. The objective of this study was to identify the main problems in medication management at transition between settings of care, as experienced by health care professionals (HCPs) and patients. Methods Focus group discussions were organised between December 2009 and February 2010; nine focus groups with primary and secondary care HCPs and patients and two with stakeholders. Focus group discussions were audiotaped and observation files were constructed. For the analysis, a thematic framework approach was used. Between November 2015 and April 2016, 19 additional interviews and 1 focus group were performed with general practitioners (GP) and community pharmacists (CP). Results This qualitative study provided a long list of problems that could be summarised in five clusters: (1) problems at admission, e.g. incomplete list of medication, absence of information in case of emergency admission; (2) problems at discharge, e.g. lack of communication with GP, insufficient supplies of medication for the weekend; (3) problems as to professions, e.g. GP's opinion different to that of the medical specialist; (4) problems as to patients and family, e.g. failure to understand treatment; (5) problems as to processes, e.g. medication substitutions. Conclusion HCPs and patients experience many problems in medication management at transition between settings of care. The fact that these problems occur at different stages and persist over time stresses the necessity for multilevel solutions.
引用
收藏
页码:263 / 271
页数:9
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