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BMC Primary Care
Published in: BMC Primary Care 1/2020

Open Access 01-12-2020 | Care | Research article

Barriers and facilitators of medicines reconciliation at transitions of care in Ireland – a qualitative study

Authors: Patrick Redmond, Khalid Munir, Oludare Alabi, Tamasine Grimes, Barbara Clyne, Carmel Hughes, Tom Fahey

Published in: BMC Primary Care | Issue 1/2020

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Abstract

Background

Medication error at transitions of care is common. The implementation of medicines reconciliation processes to improve this issue has been recommended by many regulatory and safety organisations. The aim of this study was to gain insight from healthcare professionals on the barriers and facilitators to the medicines reconciliation implementation process.

Methods

Semi-structured interviews were conducted in Ireland with a wide range of healthcare professionals (HCPs) involved with medicines reconciliation at transitions of care. Thematic analysis was undertaken using an adaptation of a combined theoretical framework of Grol, Cabana and Sluisveld to classify the barriers and facilitators to implementation of medicines reconciliation.

Results

Thirty-five participants were interviewed, including eleven community pharmacists (CPs), eight hospital pharmacists (HPs), nine hospital consultants (HCs), five general practitioners (GPs), and two non-consultant hospital doctors (NCHDs). Themes were categorized into barriers and facilitators. Barriers included resistance from existing professional cultures, staff interest and training, poor communication and minimal information and communications technology (ICT) support. Solutions (facilitators) suggested included supporting effective multidisciplinary teams, greater involvement of pharmacists in medicines reconciliation, ICT solutions (linked prescribing databases, decision support systems) and increased funding to provide additional (e.g. admission and discharge reconciliation) and more advanced services (e.g. community pharmacist delivered medicines use review).

Conclusions

Medicines reconciliation is advocated as a solution to the known problem of medication error at transitions of care. This study identifies the key challenges and potential solutions that policy makers, managers and HCPs should consider when reviewing the practices and processes of medicines reconciliation in their own organisations.
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Literature
1.
2.
National Centre for Health and Care Excellence. Medicines optimisation: the safe and effective use of medicines to enable the best possible outcomes. 2015.
3.
Institute for Healthcare Improvement. How-to Guide: Prevent Adverse Drug Events by Implementing Medication Reconciliation. Cambridge: Institute for Healthcare Improvement; 2011. Available at https://​www.​ihi.​org.
4.
Aspden P, Wolcott J, Bootman J, Cronenwett L. Preventing medication errors. Washington, D.C.: Institute of Medicine; 2006.
5.
Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50.CrossRef
6.
Grol R, Wensing M. What drives change? Barriers to and incentives for achieving evidence-based practice. Med J Aust. 2004;180(6 Suppl):S57–60.PubMed
7.
Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004;82:581–629.CrossRef
8.
Boockvar KS, Santos SL, Kushniruk A, Johnson C, Nebeker JR. Medication reconciliation: barriers and facilitators from the perspectives of resident physicians and pharmacists. J Hosp Med. 2011;6:329–37 United States LG-English DC-20110811.CrossRef
9.
Manias E, Gerdtz M, Williams A, McGuiness J, Dooley M. Communicating about the management of medications as patients move across transition points of care: an observation and interview study. J Eval Clin Pract. 2016;22 n/a-n/a.
10.
Vogelsmeier A, Pepper GA, Oderda L, Weir C. Medication reconciliation: a qualitative analysis of clinicians’ perceptions. Res Social Adm Pharm. 2013;9:419–30.CrossRef
11.
Urban R, Paloumpi E, Rana N, Morgan J. Communicating medication changes to community pharmacy post-discharge: the good, the bad, and the improvements. Int J Clin Pharm. 2013;35:813–20.CrossRef
12.
Sanchez SH, Sethi SS, Santos SL, Boockvar K. Implementing medication reconciliation from the planner’s perspective: a qualitative study. BMC Health Serv Res. 2014;14:290.CrossRef
13.
van Sluisveld N, Zegers M, Natsch S, Wollersheim H. Medication reconciliation at hospital admission and discharge: insufficient knowledge, unclear task reallocation and lack of collaboration as major barriers to medication safety. BMC Health Serv Res. 2012;12:170.CrossRef
14.
Coffey M, Cornish P, Koonthanam T, Etchells E, Matlow A. Implementation of admission medication reconciliation at two academic health sciences centres: challenges and success factors. Healthc Q. 2009;12 Spec No:102–9.CrossRef
15.
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19:349–57.CrossRef
16.
O’Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: a synthesis of recommendations. Acad Med. 2014;89:1245–51.CrossRef
17.
Grimes T, Duggan C, Delaney T. Pharmacy services at admission and discharge in adult, acute, public hospitals in Ireland. Int J Pharm Pract. 2010;18:346–52.CrossRef
18.
Grimes TC, Duggan C, Delaney TP, Graham IM, Conlon KC, Deasy E, et al. Medication details documented on hospital discharge: cross-sectional observational study of factors associated with medication non-reconciliation. Br J Clin Pharmacol. 2011;71:449–57.CrossRef
19.
Riordan CO, Delaney T, Grimes T. Exploring discharge prescribing errors and their propagation post-discharge: an observational study. Int J Clin Pharm. 2016;38:1172–81.CrossRef
20.
Ritchie J, Lewis J, Nicholls CM, Ormston R. Qualitative research practice. A guide for social science students and researchers. 2nd ed. Thousand Oaks: SAGE Publications; 2014.
21.
22.
QSR. NVivo qualitative data analysis software. 2012.
23.
Creswell JW. Qualitative inquiry and research design: choosing among five approaches. 3rd ed. Thousand Oaks: SAGE Publications; 2012.
24.
Bandura A. Social learning theory. New York City: General Learning Press; 1977.
25.
Mays N, Pope C. Qualitative research: observational methods in health care settings. BMJ. 1995;311:182–4.CrossRef
26.
Linden-Lahti C, Holmström A-R, Pennanen P, Airaksinen M. Facilitators and barriers in implementing medication safety practices across hospitals within 11 European Union countries. Pharm Pract (Granada). 2019;17:1583.CrossRef
27.
van den Bemt PM, van den Broek S, van Nunen AK, Harbers JB, Lenderink AW. Medication reconciliation performed by pharmacy technicians at the time of preoperative screening. Ann Pharmacother. 2009;43:868–74.CrossRef
28.
Machen S, Jani Y, Turner S, Marshall M, Fulop NJ. The role of organizational and professional cultures in medication safety: a scoping review of the literature. Int J Qual Heal Care. 2019;31:G146–57.
29.
Bates DW, Leape LL, Cullen DJ, Laird N, Petersen LA, Teich JM, et al. Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA. 1998;280:1311–6.CrossRef
30.
Cresswell K, Bates DW, Sheikh A. Six ways for governments to get value from health IT. Lancet. 2016;387:2074–5.CrossRef
31.
Bates DW, Kuperman GJ, Wang S, Gandhi T, Kittler A, Volk L, et al. Ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality. J Am Med Informatics Assoc. 2003;10:523–30.CrossRef
32.
Sheikh A, Cornford T, Barber N, Avery A, Takian A, Lichtner V, et al. Implementation and adoption of nationwide electronic health records in secondary care in England: final qualitative results from prospective national evaluation in “early adopter” hospitals. BMJ. 2011;343:d6054.CrossRef
33.
Pevnick JM, Shane R, Schnipper JL. The problem with medication reconciliation. BMJ Qual Saf. 2016;25:726–30.
34.
Fox WM. Sociotechnical system principles and guidelines: past and present. J Appl Behav Sci. 1995;31:91–105.CrossRef
35.
Metadata
Title
Barriers and facilitators of medicines reconciliation at transitions of care in Ireland – a qualitative study
Authors
Patrick Redmond
Khalid Munir
Oludare Alabi
Tamasine Grimes
Barbara Clyne
Carmel Hughes
Tom Fahey
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Care
Published in
BMC Primary Care / Issue 1/2020
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-020-01188-9

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