Hospital pharmacists providing drug information to psychiatric inpatients: still a long way ahead

Inpatients' information needs about medication: A narrative systematic literature review

OBJECTIVE

To provide an overview of inpatients' information needs about medication, including the best moment to provide this information, how, by whom and what patient characteristics influence these needs.

METHODS

A systematic literature review was conducted. Studies that reported the information needs from inpatients about medication were included from Medline and Embase. The Crowe critical appraisal tool (CCAT) was used to assess the quality of the studies.

RESULTS

Initially, 710 records were retrieved from Medline and Embase. After the forward search, another 609 records were screened and in total, 26 articles were included. The CCAT scores ranged from 17 to 34 points on a 40 point scale and two articles received 0 points.

CONCLUSION

Inpatients main needs about medicine information are information about adverse and beneficial effects of medication, and general rules about how to take medication. Preferably, this information is printed and provided at the time of prescribing by a physician that already has a relationship with the patient. The most recent studies show that patients are open to the use of modern technology.

PRACTICE IMPLICATIONS

This review provides a starting point for providing medicine information to inpatients. Further research should focus on patient characteristics influencing these information needs.

Expanding the role of pharmacy technicians and foundation rotational pharmacists in delivering patient-centred care at a mental health trust: development of a Medicines Optimisation Intervention Track Tool

OBJECTIVE

Medication has a significant role to play in any hospital admissionand in the road to recovery. Medication interventions to improve patient education are essential for better outcomes. Medication interventions in our unit have not previously followed a systematic procedure. They have not been quantified and do not encompass all patients. This study aims to develop a simple tool that can significantly help the effective prioritisation of the workload among the Medicines Optimisation Team, ensuring patient-centred care is optimised.

METHODS

This is an observational case series study. A basic Excel spreadsheet was designed to capture the team's daily interventions focusing on four main areas: medicines reconciliation, admission, follow-up and discharge. We named it the Medicines Optimisation Interventions Tracking Tool (MOITT).

RESULTS

Analysis of the data showed a good number of patients receiving interventions: 122 (92%) medicines reconciliation, 77 (58%) admission interventions, 64 (48%) follow-up interventions and 28 (21%) interventions on discharge. This quantification of work revealed factors which prevent achieving a higher percentage of interventions. The criteria to complete the spreadsheet were modified accordingly to address these factors resulting in an improvement in the design of the tool and the protocol to follow to complete it. In addition, it was encouraging to see the team's hard work portrayed in figures for the first time.

CONCLUSION

The MOITT developed facilitates an efficient clinical prioritisation of work for the Medicines Optimisation Team. This study has shown that this novel way of working is advantageous to record and keep track of the Medicines Optimisation Team's daily interventions on an inpatient ward, helping to set daily objectives. Implementation of this tool increases targeted patient interventions and team productivity and influences changes in practice to adapt to the service needs. The role of pharmacy technicians is critical for the implementation of this tool and patient outcomes, which is in line with the UK Hospital Pharmacy and Medicines Optimisation plan dated 2016.

Informing patients about medicines--a hospital in-patient survey in England

OBJECTIVE

To determine the frequency with which hospital in-patients receive information about medicines and whether this varies dependent on patient characteristics or hospitals.

METHODS

Cross-sectional survey of medical in-patients in six hospitals in North West England.

RESULTS

1218 questionnaires were completed sufficiently for analysis by medical in-patients. 534 (43.9%) respondents were informed fully about their medicines by a hospital doctor, nurse or pharmacist and 411 (33.9%) partly informed, but 272 (22.49%) had received no information or could not recall any. Fewer than 20% had received written medicines information. The majority of respondents (763; 62.6%) were not asked if they had any concerns or could not recall this. Patient factors including age, educational level and number of medicines taken did not influence whether or not medicines information was provided, but there were differences between hospitals.

CONCLUSION

There is considerable variation between hospitals in the frequency with which patients are given verbal and written information about medicines and are asked about any medicine-related concerns.

PRACTICE IMPLICATIONS

Informing patients about medicines while in hospital needs to be improved. Doctors, nurses and pharmacists all need to accept and co-ordinate responsibility for informing patients about medicines and asking if they have any concerns or questions.