An investigation of the opinions of community and hospital pharmacists and general practitioners of the management of drug therapy at the primary-secondary care interface



Introduction: Drug-related problems and medication errors, many preventable, are known to make a significant contribution to morbidity and mortality. The point of transfer between primacy and secondary care provides significant opportunities for medication errors to arise, especially in the absence of structured transfer protocols. There has been limited national and international research into mechanisms to facilitate seamless transfer across the primary-secondary care interface. This study attempts to identify the current arrangements that are in place and the opinions of healthcare professionals of those arrangements. Materials & Methods: The opinions of community pharmacists, hospital pharmacists and general practitioners in relation to the current procedures in place for the admission and discharge of patients, with particular reference to drug therapy, were sought. This was done by means of self-administered, anonymous, postal questionnaires which were distributed nationwide. The data were coded and analysed in SPSS v. 16. Standard statistical parameters were calculated and statistically significant relationships were determined using ANOVA and the chi-squared test where appropriate, taking p<0.05 to be significant. Results: There is currently very little communication across the interface at the time of discharge, with 10.7% of community pharmacists reporting that they have never been contacted by a hospital to inform them of the imminent discharge of a patient, with a further 79.8% stating that they were only contacted occasionally. On the other side of the interface, hospital pharmacists reported ongoing difficulties in attempting to obtain a patient medication history on admission, with 75.5% of respondents stating that they regularly, often or always encountered these difficulties. Discussions, Conclusion: The majority of community and hospital pharmacists and general practitioners were dissatisfied with the management of drug therapy during the hospital discharge process. All three groups of healthcare professionals felt that the introduction of a structured seamless care programme linking hospitals, general practitioners and community pharmacists to be important or very important. It is intended that the results of this analysis will feed into a protocol for a pilot seamless care programme based in the community pharmacy.

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