Alternatives to Post‐Discharge Home Medication Reviews for High‐Risk Patients: Doctors' and Pharmacists' Views

Abstract

Background We examined health professionals' views of a novel post‐discharge medication review model for high‐risk patients with 2 referral pathways – general practitioners (GPs) referring for home medicines reviews (HMRs) or hospital doctors referring for hospital‐initiated medication reviews (HIMRs). Aim To identify positive and negative aspects of the model, barriers and facilitators to implementation and to make recommendations for a post‐discharge home medication review program. Method 23 semi‐structured interviews were conducted with key stakeholders – hospital doctors, GPs, accredited pharmacists, hospital pharmacists and community pharmacists. Data were analysed thematically based on a conceptual framework. Results There was consensus that the availability of flexible pathways to post‐discharge home medication reviews was vital for patient care. Participants highlighted it was crucial that the patient's GP and community pharmacist are kept informed if the HIMR pathway was chosen. Barriers to implementation were time constraints experienced by health professionals to organise and conduct the review within 7 days post‐discharge and lack of awareness of the HMR process. Facilitators to implementation included existing positive working relationships and familiarity and support for the HMR process. Suggestions for future implementation included incorporating the liaison pharmacist role into the usual responsibilities of clinical pharmacists and educating medical interns about the model. Conclusion Consensus among medical and pharmacy stakeholders was that streamlined and flexible pathways to post‐discharge medication reviews would enhance quality use of medicines along the continuum of care.