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AuthorKempen, Thomas G H
AuthorKälvemark, Amanda
AuthorGillespie, Ulrika
AuthorStewart, Derek
Available date2020-02-10T08:05:43Z
Publication Date2020-02-01
Publication NameJournal of Evaluation in Clinical Practiceen_US
Identifierhttp://dx.doi.org/10.1111/jep.13121
CitationKempen, TGH, Kälvemark, A, Gillespie, U, Stewart, D. Comprehensive medication reviews by ward‐based pharmacists in Swedish hospitals: What does the patient have to say? J Eval Clin Pract. 2020; 26: 149– 157. https://doi.org/10.1111/jep.13121
URIhttp://hdl.handle.net/10576/12885
AbstractInappropriate medication prescribing and use amongst older patients is a major patient safety and health care problem. To promote appropriate medication prescribing and use, comprehensive medication reviews (CMRs) by ward-based pharmacists, including follow-up telephone calls after hospital discharge, have been conducted in older patients in the context of a randomized controlled trial (RCT). One of the key actors in a CMR is the patient. To support the understanding of the effects of CMRs on patients' health outcomes and improve clinical practice, knowledge about the patient perspective is needed. We therefore aimed to explore older patients' experiences with, and views on, hospital-initiated CMRs and follow-up telephone calls by ward-based clinical pharmacists within an RCT. We conducted in-depth semi-structured interviews with 15 patients (66-94 years) and carers from four hospitals in Sweden. Discussion topics included communication, information, decision-making, and effects on the patient. Interviews took place after discharge, were audio-recorded, transcribed verbatim, and thematically analysed using a framework approach. In general, patients' experiences and views were positive. Seven key themes were identified: (a) feeling of being taken care of and heterogenous health effects; (b) the pharmacist is competent; (c) despite the unclear role of pharmacists, their involvement is appreciated; (d) patients rely on health care professionals for decision-making; (e) importance of being informed, but receiving and retaining information is problematic; (f) time, location, and other factors influencing the effectiveness of CMRs; and (g) generic substitution is a problem. Older patients generally have positive experiences with and views on CMRs and follow-up telephone calls. However, some factors, like the unclear role of the ward-based pharmacist and problems with receiving and retaining information, may negatively impact the effectiveness of these interventions. Future initiatives on hospital-initiated CMRs by clinical pharmacists should address these negative factors and utilize the positive views.
Languageen
PublisherWiley
Subjectclinical pharmacists
Subjecthealth services for the aged
Subjectinterdisciplinary health team
Subjectpatient involvement
Subjectqualitative research
Subjectreview, drug utilization
TitleComprehensive medication reviews by ward-based pharmacists in Swedish hospitals: What does the patient have to say?
TypeArticle
Pagination149-157
Issue Number1
Volume Number26


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