Junior doctors’ communication with hospital pharmacists about prescribing: findings from a qualitative interview study

Abstract

ObjectivesTo explore factors affecting communication between Foundation Year (FY) 1 doctors and hospital pharmacists about prescribing from the junior doctors’ perspective.MethodsTrained interviewers (n=4) conducted semistructured interviews with FY1 doctors who were purposively sampled from three hospitals in England. FY1 doctors were asked about their experiences of communication with hospital pharmacists about their prescribing; instances where they disagreed with or did not implement a hospital pharmacist’s recommendation; and their preferences for communicating with hospital pharmacists about prescribing. Interviews were audiorecorded, transcribed verbatim and analysed thematically.ResultsA total of 27 FY1 doctors were interviewed. Findings were categorised into four main themes: (1) nature and context of communication; (2) FY1 doctors’ perceptions of communication with hospital pharmacists; (3) factors influencing FY1 doctors’ decision whether to act on pharmacists’ prescribing recommendations; and (4) suggestions to improve communication with pharmacists. FY1 doctors and hospital pharmacists generally communicated well. FY1 doctors appreciated and frequently acted on pharmacists’ advice yet there was deference to senior medical staff when advice differed. Joint ward rounds, pharmacist-led teaching sessions and a standardised approach to communication were all suggested as ways to improve communication and may increase the likelihood of pharmacists’ recommendations being acted on.ConclusionsFY1 doctors and hospital pharmacists communicated frequently about medication prescribing. Issues occurred when there were differences in professional judgement between senior medical staff and pharmacists but these were usually resolved satisfactorily for the FY1 doctor. Further interventions to improve communication and safe prescribing could involve a multidisciplinary and systems approach.

Education around medication review and deprescribing: a survey of medical and pharmacy students’ perspectives

“…Interestingly, MBBS students were more likely compared with MPharm students to find the support of pharmacists useful to them, perhaps in acknowledgement of the medicines expertise of pharmacists. 21 We consider that our bottom-up approach to education around medication review and deprescribing, and other educational strategies should be complemented by continuing to acknowledge barriers to deprescribing and how senior clinicians can, where appropriate, seek to overcome them. The outcomes of our study will include an undergraduate IPE on medication review at King’s College London.…”

Assessing the Effect of a Telepharmacist’s Recommendations During an Integrated, Interprofessional Telehealth Appointment and Their Alignment with Quality Measures

“…Previous research has shown that greater access to pharmacists and shared decision making improved communication between health care professionals. 20 As such, telepharmacists can offer a range of clinical interventions related to adherence, safety, gaps in care, vaccines, and cost savings, further illustrating their value to telehealth teams in caring for patients with multiple conditions, including epilepsy. 13 Despite the considerable number of recommendations made by the telepharmacist, the majority failed to align with any HEDIS measures.…”

A Systematic Scoping Review on Pedagogical Strategies of Interprofessional Communication for Physicians in Emergency Medicine

“… 21 , 32 The impact of these gaps in training are further underscored amidst growing public attention on bed crises, overcrowding, and mounting waiting times. 21 , 39 – 42 …”

“…21,32 The impact of these gaps in training are further underscored amidst growing public attention on bed crises, overcrowding, and mounting waiting times. 21,[39][40][41][42] With a consistent approach to IPC training in EM continuing to elude practice, [43][44][45][46] and guided by the importance placed upon it by the Accreditation Council for Graduate Medical Education (ACGME) 20,23 and the Institute of Medicine, 11,25,26,[47][48][49][50] we seek to evaluate regnant accounts of IPC training in EM to attend to this gap in understanding 27,51 and guide efforts to design a setting specific training approach. 11,[52][53][54][55]…”