UK hospital patient discharge: the patient perspective

Wright, Sally; Morecroft, C; Mullen, Rachel; Ewing, Alison B

doi:10.1136/ejhpharm-2016-001134

Cited by 13 publications

(22 citation statements)

References 7 publications

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“…The current study sheds light on several issues related to patients’ perceptions regarding counselling about medications and SDM and their awareness of community pharmacy services that could enhance understanding of their medications and conditions. The generated results clearly identified that there is a lack of detailed medication counselling and patients’ involvement in SDM, which echo previous findings in the literature [ 5 , 25 ]. Underutilisation of community pharmacy services was also highlighted in this study by the lack of awareness among target patients about services related to medication optimisation and counselling which can be promptly and easily accessible at primary care level.…”

Section: Discussionsupporting

confidence: 86%

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Shared decision making and experiences of patients with long-term conditions: has anything changed?

Kayyali

Nabhani‐Gebara

Hesso

et al. 2018

BMC Health Serv Res

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BackgroundMedication problems among patients with long-term conditions (LTCs) are well documented. Measures to support LTC management include: medicine optimisation services by community pharmacists such as the Medicine Use Review (MUR) service in England, implementation of shared decision making (SDM), and the availability of rapid access clinics in primary care. This study aimed to investigate the experience of patients with LTCs about SDM including medication counselling and their awareness of community pharmacy medication review services.MethodsA mixed research method with a purposive sampling strategy to recruit patients was used. The quantitative phase involved two surveys, each requiring a sample size of 319. The first was related to SDM experience and the second to medication counselling at discharge. Patients were recruited from medical wards at St. George’s and Croydon University Hospitals.The qualitative phase involved semi-structured interviews with 18 respiratory patients attending a community rapid access clinic. Interviews were audio-recorded and transcribed verbatim. Thematic analysis using inductive/deductive approaches was employed. Survey results were analysed using descriptive statistics.ResultsThe response rate for surveys 1 and 2 survey was 79% (n = 357/450) and 68.5% (240/350) respectively. Survey 1 showed that although 70% of patients had changes made to their medications, only 40% were consulted about them and two-thirds (62.2%) wanted to be involved in SDM. In survey 2, 37.5% of patients thought that medication counselling could be improved. Most patients (88.8%) were interested in receiving the MUR service; however 83% were not aware of it. The majority (57.9%) were interested in receiving their discharge medications from community pharmacies. The interviews generated three themes; lack of patient-centered care and SDM, minimal medication counselling provided and lack of awareness about the MUR service.ConclusionAlthough patients wanted to take part in SDM, yet SDM and medication counselling are not optimally provided. Patients were interested in the MUR service; however there was lack of awareness and referral for this service. The results propose community pharmacy as a new care pathway for medication supply and counselling post discharge. This promotes a change of health policy whereby community-based services are used to enhance the performance of acute hospitals.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3575-y) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 86%

“…A new finding revealed in this study was patients’ preference for receiving their discharge medications from community pharmacies. This could provide a solution for the delay in discharge related to the long wait for discharge medications highlighted in the literature [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Shared decision making and experiences of patients with long-term conditions: has anything changed?

Kayyali

Nabhani‐Gebara

Hesso

et al. 2018

BMC Health Serv Res

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“…This finding is consistent with the study of 104 medical and surgical inpatients, which highlight the lack of patients’ involvement with their healthcare decision. Only 22% of the participants reported participation with the decision making about their discharge and commented that they were sent home too early (Wright, Morecroft, Mullen, & Ewing, ). To increase their health knowledge, our study participants accessed informal information source like the internet to self‐manage their recovery and to influence their decision for seeking help after discharge.…”

Section: Discussionmentioning

confidence: 99%

“…This finding is consistent with the study of 104 medical and surgical inpatients, which highlight the lack of patients' involvement with their healthcare decision. Only 22% of the participants reported participation with the decision making about their discharge and commented that they were sent home too early (Wright, Morecroft, Mullen, & Ewing, 2017 2014), and provided online tools and resources to support consumers to be active participant in their healthcare decisions. Though we did not specifically explore patients' health literacy and their role in the decision making of their care in this study, it has been suggested that increasing patients' level of health literacy enables them to play a more active role in the decision making of their health process (Brabers, Rademakers, Groenewegen, van Dijk, & de Jong, 2017).…”

Section: Patients' Participation and Health Literacymentioning

confidence: 99%

General surgical patients’ experience of hospital discharge education: A qualitative study

Kang

Gillespie

Tobiano

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To explore adult general surgical patients’ perceptions of, and satisfaction with, discharge education provided by healthcare providers. Background Discharge education is essential for general surgical patients as it equips them with the required knowledge and skills to engage in their care after discharge. Insufficient knowledge to self‐manage or assess their symptoms can result in postdischarge complications, unplanned hospital readmission and overall dissatisfaction with the hospital experience. Design A constructivist‐interpretivist paradigm using qualitative interviews. Methods Telephone interviews were conducted with 13 patients between August 2018 and November 2018 and analysed using inductive content analysis. COREQ guidelines were adopted for the conduct and reporting of the study. Results Four themes were uncovered: (a) The quality of discharge information influences patients’ postdischarge experience; (b) The negative impact of contextual influences on delivery of discharge education; (c) Patients actively participating in their surgical journey; (d) Patients’ preferences with the delivery of discharge education. Conclusion Inadequate discharge education leads to patients’ inability to self‐manage their recovery process. Information sharing with patients fosters shared understanding towards goals and expectations. Relevance to clinical practice Understanding patients’ view may inform the design of patient‐centred discharge education interventions for patients to self‐manage their recovery postdischarge.

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“…Wright and colleagues1 report on a single-centre survey of inpatient perceptions and experiences of the current discharge process, and identify improvement opportunities in relation to waiting for medicines and lack of counselling by pharmacists. Problems such as low awareness among inpatients of pharmacy services or pharmacists citing challenges to achieving patient medication counselling have been reported internationally 2 3…”

mentioning

confidence: 99%