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Zahl-Holmstad B, Garcia BH, Johnsgård T, Ofstad EH, Lehnbom EC, Svendsen K, Risør T, Holis RV, Elenjord R. Patient perceptions and experiences with medication-related activities in the emergency department: a qualitative study. BMJ Open Qual 2023; 12:bmjoq-2022-002239. [PMID: 37217242 DOI: 10.1136/bmjoq-2022-002239] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 05/02/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Emergency department (ED) pharmacists reduce medication errors and improve quality of medication use. Patient perceptions and experiences with ED pharmacists have not been studied. The aim of this study was to explore patients' perceptions of and experiences with medication-related activities in the ED, with and without an ED pharmacist present. METHODS We conducted 24 semistructured individual interviews with patients admitted to one ED in Norway, 12 before and 12 during an intervention, where pharmacists performed medication-related tasks close to patients and in collaboration with ED staff. Interviews were transcribed and analysed applying thematic analysis. RESULTS From our five developed themes, we identified that: (1) Our informants had low awareness and few expectations of the ED pharmacist, both with and without the pharmacist present. However, they were positive to the ED pharmacist. (2) Our informants expressed a variation of trust in the healthcare system, healthcare professionals and electronic systems, though the majority expressed a high level of trust. They believed that their medication list was automatically updated and assumed to get the correct medication. (3) Some informants felt responsible to have an overview of their medication use, while others expressed low interest in taking responsibility regarding their medication. (4) Some informants did not want involvement from healthcare professionals in medication administration, while others expressed no problems with giving up control. (5) Medication information was important for all informants to feel confident in medication use, but the need for information differed. CONCLUSION Despite being positive to pharmacists, it did not seem important to our informants who performed the medication-related tasks, as long as they received the help they needed. The degree of trust, responsibility, control and information varied among ED patients. These dimensions can be applied by healthcare professionals to tailor medication-related activities to patients' individual needs.
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Affiliation(s)
- Birgitte Zahl-Holmstad
- Hospital Pharmacy of North Norway Trust, Tromsø, Norway
- Department of Pharmacy, UiT The Arctic University of Norway, Tromsø, Norway
| | - Beate Hennie Garcia
- Hospital Pharmacy of North Norway Trust, Tromsø, Norway
- Department of Pharmacy, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tine Johnsgård
- Hospital Pharmacy of North Norway Trust, Tromsø, Norway
- Department of Pharmacy, UiT The Arctic University of Norway, Tromsø, Norway
| | - Eirik Hugaas Ofstad
- Department of Medicine, Nordland Hospital Trust, Bodø, Norway
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Elin Christina Lehnbom
- Department of Pharmacy, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
| | - Kristian Svendsen
- Department of Pharmacy, UiT The Arctic University of Norway, Tromsø, Norway
| | - Torsten Risør
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Public Health, University of Copenhagen, København, Denmark
| | | | - Renate Elenjord
- Hospital Pharmacy of North Norway Trust, Tromsø, Norway
- Department of Pharmacy, UiT The Arctic University of Norway, Tromsø, Norway
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Walquist MJ, Svendsen K, Garcia BH, Bergmo TS, Eggen AE, Halvorsen KH, Småbrekke L, Ringberg U, Lehnbom EC, Waaseth M. Self-reported medication information needs among medication users in a general population aged 40 years and above - the Tromsø study. BMC Public Health 2022; 22:2182. [PMID: 36434564 PMCID: PMC9700964 DOI: 10.1186/s12889-022-14573-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To determine the prevalence and associated factors of self-reported medication information needs among medication users in a general population aged 40 years and above - The Tromsø Study. METHODS Cross-sectional study of medication users (n = 10,231) among participants in the Tromsø Study, a descriptive analysis of questionnaire data and multivariable logistic regression (n = 9,194). RESULTS Sixteen percent of medication users expressed a need for more information about own medications. Overall, medication users agreed to a higher degree to have received information from the GP compared to the pharmacy. Concerned medication users and those disagreeing to have received information about side effects had the highest odds for needing more information (OR 5.07, 95% CI 4.43-5.81) and (OR 2.21, 95% CI 1.83-2.68), respectively. Medication users who used heart medications (e.g., nitroglycerin, antiarrhythmics, anticoagulants) (OR 1.71, 95% CI 1.46-2.01), medication for hypothyroidism (OR 1.36, 95% CI 1.13-1.64) or had moderately health anxiety had expressed need for medication information. Whereas medication users with lower education, those that never used internet to search for health advice, and medication users who disagreed to have received information about reason-for-use were associated with lower odds (OR 0.75, 95% CI 0.62-0.91), (OR 0.85, 95% CI 0.74-0.98) and (OR 0.68, 95% CI 0.53-0.88), respectively. CONCLUSION This study demonstrated that there is need for more information about own medications in a general population aged 40 years and above and shed light on several characteristics of medication users with expressed information need which is important when tailoring the right information to the right person.
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Affiliation(s)
- Mari J. Walquist
- grid.10919.300000000122595234Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway ,grid.10919.300000000122595234Norwegian College of Fishery Science, The Faculty of biosciences, fisheries and economics, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kristian Svendsen
- grid.10919.300000000122595234Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Beate H. Garcia
- grid.10919.300000000122595234Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Trine S. Bergmo
- grid.10919.300000000122595234Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway ,grid.412244.50000 0004 4689 5540Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway
| | - Anne Elise Eggen
- grid.10919.300000000122595234Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kjell H. Halvorsen
- grid.10919.300000000122595234Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Lars Småbrekke
- grid.10919.300000000122595234Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Unni Ringberg
- grid.10919.300000000122595234Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Elin C. Lehnbom
- grid.10919.300000000122595234Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Marit Waaseth
- grid.10919.300000000122595234Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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3
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Ingemann C, Hansen NF, Hansen NL, Jensen K, Larsen CVL, Chatwood S. Patient experience studies in the circumpolar region: a scoping review. BMJ Open 2020; 10:e042973. [PMID: 33020108 PMCID: PMC7537463 DOI: 10.1136/bmjopen-2020-042973] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Patient experiences with health systems constitute a crucial pillar of quality care. Across the Arctic, patients' interactions with the healthcare system are influenced by challenges of access, historical inequities and social determinants. This scoping review sought to describe the range and nature of peer-reviewed literature on patient experience studies conducted within the circumpolar region. DESIGN In a partnership between Danish/Greenlandic, Canadian and American research teams, a scoping review of published research exploring patient experiences in circumpolar regions was undertaken. DATA SOURCES Seven electronic databases were queried: MEDLINE, Embase, Scopus, 'Global Health 1910 to 2019 Week 11', CINAHL, PsycINFO and SveMed+. ELIGIBILITY CRITERIA Articles were eligible for inclusion if they (a) took place in the circumpolar region, (b) reported patients' perspective and (c) were focussed primarily on patient experiences with care, rather than satisfaction with treatment outcome. DATA EXTRACTION AND SYNTHESIS Title and abstract screening, full-text review and data extraction was conducted by four researchers. Bibliometric information such as publication date and country of origin was extracted, as was information regarding study design and whether or not the article contained results relevant to the themes of Indigenous values, rural and remote context, telehealth and climate change. Two researchers then synthesised and characterised results relevant to these themes. RESULTS Of the 2824 articles initially found through systematic searches in seven databases, 96 articles were included for data extraction. Findings from the review included unique features related to Indigenous values, rural and remote health, telehealth and climate change. CONCLUSIONS The review findings provide an overview of patient experiences measures used in circumpolar nations. These findings can be used to inform health system improvement based on patient needs in the circumpolar context, as well as in other regions that share common features. This work can be further contextualized through Indigenous methodologies such as sharing circles and community based participatory methods.
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Affiliation(s)
- Christine Ingemann
- National Institute of Public Health, University of Southern Denmark Faculty of Health Sciences, Copenhagen, Denmark
- Institute of Nursing and Health Sciences, University of Greenland, Nuuk, Greenland
| | | | - Nanna Lund Hansen
- National Institute of Public Health, University of Southern Denmark Faculty of Health Sciences, Copenhagen, Denmark
| | - Kennedy Jensen
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Christina Viskum Lytken Larsen
- National Institute of Public Health, University of Southern Denmark Faculty of Health Sciences, Copenhagen, Denmark
- Institute of Nursing and Health Sciences, University of Greenland, Nuuk, Greenland
| | - Susan Chatwood
- University of Alberta School of Public Health, Edmonton, Alberta, Canada
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4
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Amin MEK, Nørgaard LS, Cavaco AM, Witry MJ, Hillman L, Cernasev A, Desselle SP. Establishing trustworthiness and authenticity in qualitative pharmacy research. Res Social Adm Pharm 2020; 16:1472-1482. [PMID: 32067887 DOI: 10.1016/j.sapharm.2020.02.005] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 01/31/2020] [Accepted: 02/10/2020] [Indexed: 10/25/2022]
Abstract
Spurred by the value it can add, the use of qualitative research methods has been steadily growing by social pharmacy researchers around the globe, either separately or as part of mixed methods research projects. Given this increase, it is important to provide guidance to assist researchers in ensuring quality when employing such methods. This commentary addresses both theoretical fundamentals as well as practical aspects of establishing quality in qualitative social pharmacy research. More specifically, it provides an explanation of each of the criteria of trustworthiness proposed by Lincoln and Guba (credibility, transferability, dependability and confirmability) and different techniques used in establishing them. It also provides a brief overview of authenticity, a more recent and less widely used set of criteria that involve demonstrating fairness, ontological authenticity, educative authenticity, catalytic authenticity, and tactical authenticity. For each of these terms, the commentary provides a definition, how it applies to social pharmacy research, and guidance on when and how to use them. These are accompanied by examples from the pharmacy literature where the criteria have been used. The commentary ends by providing a summary of competing viewpoints of establishing quality in the published literature while inviting the reader to reflect on how the presented criteria would apply to different qualitative research projects.
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Affiliation(s)
| | - Lotte Stig Nørgaard
- Department of Pharmacy, University of Copenhagen, Universitetsparken 2, Building: 17-5-504, 2100, København Ø, Denmark.
| | - Afonso M Cavaco
- Faculty of Pharmacy, University of Lisbon, Av. Prof. Gama Pinto, 1649-003, Lisboa, Portugal.
| | - Matthew J Witry
- College of Pharmacy, University of Iowa, 115 S. Grand Avenue, Iowa City, IA, 52242, USA.
| | - Lisa Hillman
- College of Pharmacy, University of Minnesota, 7-159 Weaver-Densford Hall, 308, Harvard St. SE, Minneapolis, MN, 55455, USA.
| | - Alina Cernasev
- The University of Tennessee Health Science Center, College of Pharmacy, 301 S Perimeter Park Drive, Suite 220, Nashville, TN, 37211, USA.
| | - Shane P Desselle
- Touro University, California College of Pharmacy, Applied Pharmacy Solutions, 1310 Club Dr, Vallejo, CA, 94592, USA.
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5
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Kempen 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. [PMID: 30834647 DOI: 10.1111/jep.13121] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/07/2019] [Accepted: 02/09/2019] [Indexed: 12/26/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVES Inappropriate 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Thomas G H Kempen
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,Hospital Pharmacy Department, Uppsala University Hospital, Uppsala, Sweden
| | - Amanda Kälvemark
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Ulrika Gillespie
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Derek Stewart
- School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, UK.,College of Pharmacy, Qatar University, Doha, Qatar
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6
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Haga SB, Moaddeb J, Mills R, Voora D. Assessing feasibility of delivering pharmacogenetic testing in a community pharmacy setting. Pharmacogenomics 2017; 18:327-335. [PMID: 28244804 DOI: 10.2217/pgs-2016-0175] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
AIM To describe the rationale and design of a study evaluating the delivery of pharmacogenetic (PGx) testing in community pharmacies. Study rationale: Pharmacists have expressed interest in offering PGx testing; however, their lack of knowledge and experience, patients' acceptance and feasibility are unknown in this setting. STUDY DESIGN Through a cluster randomized trial, we will assess pharmacist and patient experiences with delivery of PGx testing as a standalone service or integrated into medication therapy management services. Anticipated results: We anticipate that PGx testing can be delivered in a community pharmacy setting and accepted and valued by patients. CONCLUSION This study is expected to provide valuable evidence about the real-world feasibility and acceptance of a community pharmacist-delivered approach of PGx testing.
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Affiliation(s)
- Susanne B Haga
- Center for Applied Genomics & Precision Medicine, Duke University School of Medicine, 304 Research Drive, Box 90141, Durham, NC 27708, USA
| | - Jivan Moaddeb
- Center for Applied Genomics & Precision Medicine, Duke University School of Medicine, 304 Research Drive, Box 90141, Durham, NC 27708, USA
| | - Rachel Mills
- Center for Applied Genomics & Precision Medicine, Duke University School of Medicine, 304 Research Drive, Box 90141, Durham, NC 27708, USA
| | - Deepak Voora
- Center for Applied Genomics & Precision Medicine, Duke University School of Medicine, 304 Research Drive, Box 90141, Durham, NC 27708, USA
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7
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Kang JE, Han NY, Oh JM, Jin HK, Kim HA, Son IJ, Rhie SJ. Pharmacist-involved care for patients with heart failure and acute coronary syndrome: a systematic review with qualitative and quantitative meta-analysis. J Clin Pharm Ther 2016; 41:145-57. [DOI: 10.1111/jcpt.12367] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 02/01/2016] [Indexed: 11/27/2022]
Affiliation(s)
- J. E. Kang
- Division of Life and Pharmaceutical Sciences Graduate School and College of Pharmacy; Ewha Womans University; Seoul Korea
- Department of Pharmacy; National Medical Center; Seoul Korea
| | - N. Y. Han
- College of Pharmacy; Seoul National University; Seoul Korea
| | - J. M. Oh
- College of Pharmacy; Seoul National University; Seoul Korea
| | - H. K. Jin
- Division of Life and Pharmaceutical Sciences Graduate School and College of Pharmacy; Ewha Womans University; Seoul Korea
| | - H. A. Kim
- Division of Life and Pharmaceutical Sciences Graduate School and College of Pharmacy; Ewha Womans University; Seoul Korea
| | - I. J. Son
- Department of Pharmacy; National Medical Center; Seoul Korea
| | - S. J. Rhie
- Division of Life and Pharmaceutical Sciences Graduate School and College of Pharmacy; Ewha Womans University; Seoul Korea
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8
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Short V, Atkinson C, Ness AR, Thomas S, Burden S, Sutton E. Patient experiences of perioperative nutrition within an Enhanced Recovery After Surgery programme for colorectal surgery: a qualitative study. Colorectal Dis 2016; 18:O74-80. [PMID: 26682875 PMCID: PMC4755035 DOI: 10.1111/codi.13245] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 10/26/2015] [Indexed: 02/08/2023]
Abstract
AIM Nutrition is an important element of the Enhanced Recovery After Surgery (ERAS) programme. Patients have previously indicated that nutrition is a key component of ERAS that requires improvement. Our aim was to explore the perioperative nutrition experiences of colorectal surgical patients to identify barriers and facilitators to the integration of nutrition within ERAS. METHOD Sixteen individuals undergoing colorectal surgery participated in a semi-structured interview between postoperative day three and hospital discharge. The topic guide was developed iteratively throughout the study; topics included preoperative counselling, carbohydrate loading, fasting and postoperative nutrition. A constant comparison technique was employed during coding, and an inductive thematic analysis was used. Validity was ensured by double coding a sample of transcripts. RESULTS Findings are presented in the context of the following clinical themes: preoperative information, preoperative fasting, carbohydrate loading and nutritional drinks, postoperative diet and discharge. Individuals received too much general information which was repetitive, contradictory and not disease specific; this formed a key barrier affecting nutrition. Other barriers were negative experiences of nutritional drinks, stoma management, nausea and vomiting, and challenges from the hospital environment. Facilitators included interactions with staff, food accessibility and choice, and motivation for discharge. CONCLUSION The key barrier to adherence of perioperative nutrition protocols was poor provision of information. Targeted information regarding postoperative diet, stoma management and coping with nausea and vomiting would be beneficial for colorectal surgical patients. Easily accessible food provided by ward staff was considered a facilitator.
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Affiliation(s)
- V. Short
- NIHR Biomedical Research Unit in Nutrition, Diet and LifestyleUniversity Hospitals Bristol Education CentreBristolUK
| | - C. Atkinson
- NIHR Biomedical Research Unit in Nutrition, Diet and LifestyleUniversity Hospitals Bristol Education CentreBristolUK
| | - A. R. Ness
- NIHR Biomedical Research Unit in Nutrition, Diet and LifestyleUniversity Hospitals Bristol Education CentreBristolUK
| | - S. Thomas
- Head and Neck SurgeryUniversity Hospitals Bristol NHS TrustBristolUK
| | - S. Burden
- School of Nursing, Midwifery and Social WorkUniversity of ManchesterManchesterUK
| | - E. Sutton
- NIHR Biomedical Research Unit in Nutrition, Diet and LifestyleUniversity Hospitals Bristol Education CentreBristolUK
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9
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Lim SY, Jarvenpaa SL, Lanham HJ. Barriers to Interorganizational Knowledge Transfer in Post-Hospital Care Transitions: Review and Directions for Information Systems Research. J MANAGE INFORM SYST 2015. [DOI: 10.1080/07421222.2015.1095013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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10
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Garcia BH, Giverhaug T, Høgli JU, Skjold F, Småbrekke L. A pharmacist-led follow-up program for patients with established coronary heart disease in North Norway - a randomized controlled trial. Pharm Pract (Granada) 2015; 13:575. [PMID: 26131047 PMCID: PMC4482847 DOI: 10.18549/pharmpract.2015.02.575] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 06/07/2015] [Indexed: 11/29/2022] Open
Abstract
Objectives: The aim of the study was twofold; 1) to develop a clinical pharmacist-led 12 month lasting follow-up program for patients with established coronary heart disease (CHD) discharged from the University Hospital of North Norway, and 2) to explore the impact of the program with regards to adherence to a medication assessment tool for secondary prevention of CHD and change in biomedical risk factors. Methods: A total of 102 patients aged 18-82 years were enrolled in a non-blinded randomized controlled trial with an intervention group and a control group. The intervention comprised medication reconciliation, medication review and patient education during three meetings; at discharge, after three months and after twelve months. The control group received standard care from their general practitioner. Primary outcomes were adherence to clinical guideline recommendations concerning prescription, therapy goal achievement and lifestyle education defined in the medication assessment tool for secondary prevention of CHD (MAT-CHDSP). Secondary outcomes included changes in the biomedical risk factors cholesterol, blood pressure and blood glucose. Results: Ninety-four patients completed the trial, 48 intervention group patients and 46 controls. Appropriate prescribing was high, but therapy goal achievement was low in both groups. Overall adherence to MAT-CHDSP criteria increased in both groups and was significantly higher in the intervention group at study end, 78.4% vs. 62.0%, p<0.001. The difference was statistically significant for the documented lifestyle advices in intervention group patients. No significant improvements in biomedical risk factors were observed in favor of the intervention group. Conclusions: The study showed an increased guideline adherence in both study groups. This indicates that attention to clinical practice guideline recommendations in itself increases adherence – which may be a clinical pharmacist task. A larger adequately powered study is needed to show a significant difference in biomedical risk factor improvements in favor of the intervention. Amendments to the follow-up program are suggested before implementation in standard patient care can be recommended.
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Affiliation(s)
- Beate H Garcia
- Hospital Pharmacy of North Norway; & Department of Pharmacy, University of Tromsø . Tromsø ( Norway ).
| | - Trude Giverhaug
- Regional Drug Information Center of North Norway & University Hospital of North-Norway. Tromsø ( Norway ).
| | - June U Høgli
- Department of Pharmacy, University of Tromsø . Tromsø ( Norway ).
| | - Frode Skjold
- Department of Pharmacy, University of Tromsø , Tromsø ( Norway ).
| | - Lars Småbrekke
- Department of Pharmacy, University of Tromsø . Tromsø ( Norway ).
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