School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, New South Wales, Australia.
Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
BMJ Open. 2024 May 22;14(5):e082228. doi: 10.1136/bmjopen-2023-082228.
Hospitalisation due to medication-related problems is a major health concern, particularly for those with pre-existing, or those at high risk of developing cardiovascular disease (CVD). Postdischarge medication reviews (PDMRs) may form a core component of reducing hospital readmissions due to medication-related problems. This study aimed to explore postdischarge CVD patients' perspectives of, and experiences with, pharmacist-led medication management services. A secondary aim explored attitudes towards the availability of PDMRs.
An interpretative qualitative study involving 16 semistructured interviews. Data were analysed using an inductive thematic approach.
Patients with CVD discharged to a community setting from the John Hunter Hospital, an 820-bed tertiary referral hospital based in New South Wales, Australia.
Patients with pre-existing or newly diagnosed CVD who were recently discharged from the hospital.
A total of 16 interviews were conducted to reach thematic saturation. Nine participants (56%) were male. The mean age of participants was 57.5 (±13.2) years. Three emergent themes were identified: (1) poor medication understanding impacts transition from the hospital to home; (2) factors influencing medication concordance following discharge and (3) perceived benefits of routine PDMRs.
There is a clear need to further improve the quality use of medicines and health literacy of transition-of-care patients with CVD. Our findings indicate that the engagement of transition-of-care patients with CVD with pharmacist-led medication management services is minimal. Pharmacists are suitable to provide essential and tailored medication review services to patients with CVD as part of a multidisciplinary healthcare team. The implementation of routine, pharmacist-led PDMRs may be a feasible means of providing patients with access to health education following their transition from hospital back to community, improving their health literacy and reducing rehospitalisations due to medication-related issues.
因药物相关问题导致的住院是一个主要的健康关注点,特别是对于那些患有预先存在的或有发展为心血管疾病(CVD)风险的患者。出院后药物审查(PDMR)可能是减少因药物相关问题导致的住院再入院的核心组成部分。本研究旨在探讨出院后 CVD 患者对药剂师主导的药物管理服务的看法和体验。次要目的是探讨对 PDMR 可用性的态度。
一项涉及 16 次半结构式访谈的解释性定性研究。使用归纳主题方法进行数据分析。
从澳大利亚新南威尔士州约翰亨特医院(一家拥有 820 张床位的三级转诊医院)出院到社区环境的 CVD 患者。
患有预先存在或新诊断的 CVD 的患者,他们最近从医院出院。
共进行了 16 次访谈以达到主题饱和。9 名参与者(56%)为男性。参与者的平均年龄为 57.5(±13.2)岁。确定了三个主题:(1)药物理解差会影响从医院到家庭的过渡;(2)影响出院后药物一致性的因素;(3)常规 PDMR 的感知益处。
显然需要进一步提高 CVD 过渡护理患者的药物合理使用和健康素养。我们的研究结果表明,CVD 过渡护理患者与药剂师主导的药物管理服务的互动很少。药剂师适合作为多学科医疗团队的一部分,为 CVD 患者提供必要的、量身定制的药物审查服务。常规、由药剂师主导的 PDMR 的实施可能是为患者提供从医院过渡到社区后接受健康教育的可行方法,提高他们的健康素养并减少因药物相关问题导致的再住院。