Pharmacist-led medication reconciliation service for patients after discharge from tertiary hospitals to primary care in Singapore: a qualitative study

Background: Medication discrepancies commonly occur when patients are transferred between care settings. Despite the presence of medication reconciliation services (MRS), medication discrepancies are still prevalent, which has clinical costs and implications. This study aimed to explore the perspect...

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Main Authors: Griva, Konstadina, Chua, Zi Yang, Lai, Lester Yousheng, Xu, Sandra Jialun, Bek, Esther Siew Joo, Lee, Eng Sing
Other Authors: Lee Kong Chian School of Medicine (LKCMedicine)
Format: Article
Language:English
Published: 2024
Subjects:
Online Access:https://hdl.handle.net/10356/175587
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Institution: Nanyang Technological University
Language: English
id sg-ntu-dr.10356-175587
record_format dspace
institution Nanyang Technological University
building NTU Library
continent Asia
country Singapore
Singapore
content_provider NTU Library
collection DR-NTU
language English
topic Medicine, Health and Life Sciences
Medication reconciliation service
Medication discrepancies
spellingShingle Medicine, Health and Life Sciences
Medication reconciliation service
Medication discrepancies
Griva, Konstadina
Chua, Zi Yang
Lai, Lester Yousheng
Xu, Sandra Jialun
Bek, Esther Siew Joo
Lee, Eng Sing
Pharmacist-led medication reconciliation service for patients after discharge from tertiary hospitals to primary care in Singapore: a qualitative study
description Background: Medication discrepancies commonly occur when patients are transferred between care settings. Despite the presence of medication reconciliation services (MRS), medication discrepancies are still prevalent, which has clinical costs and implications. This study aimed to explore the perspectives of various stakeholders on how the MRS can be optimized in Singapore. Methods: This is a descriptive qualitative study. Semi-structured interviews with 30 participants from the National Healthcare Group, including family physicians (N = 10), pharmacists (N = 10), patients recently discharged from restructured hospitals (N = 7) and their caregivers (N = 3) were conducted. All transcribed interviews were coded independently by three coders and inductive thematic analysis approach was used. Results: Five core themes were identified. (1) The MRS enhanced healthcare services in various aspects including efficiency and health literacy; (2) There were several challenges in delivering the MRS covering processes, technology and training; (3) Issues with suitable patient selection and follow-up; (4) Barriers to scaling up of MRS that involve various stakeholders, cross-sector integration and environmental restrictions; and finally (5) Role definition of the pharmacist to all the stakeholders. Conclusion: This study identified the role of MRS in enhancing healthcare services and explored the challenges encountered in the provision of MRS from family physicians, pharmacists, patients and their caregivers. These findings supported the need for a shift of MRS towards a more comprehensive medication review model. Future improvement work to the MRS can be conducted based on the findings.
author2 Lee Kong Chian School of Medicine (LKCMedicine)
author_facet Lee Kong Chian School of Medicine (LKCMedicine)
Griva, Konstadina
Chua, Zi Yang
Lai, Lester Yousheng
Xu, Sandra Jialun
Bek, Esther Siew Joo
Lee, Eng Sing
format Article
author Griva, Konstadina
Chua, Zi Yang
Lai, Lester Yousheng
Xu, Sandra Jialun
Bek, Esther Siew Joo
Lee, Eng Sing
author_sort Griva, Konstadina
title Pharmacist-led medication reconciliation service for patients after discharge from tertiary hospitals to primary care in Singapore: a qualitative study
title_short Pharmacist-led medication reconciliation service for patients after discharge from tertiary hospitals to primary care in Singapore: a qualitative study
title_full Pharmacist-led medication reconciliation service for patients after discharge from tertiary hospitals to primary care in Singapore: a qualitative study
title_fullStr Pharmacist-led medication reconciliation service for patients after discharge from tertiary hospitals to primary care in Singapore: a qualitative study
title_full_unstemmed Pharmacist-led medication reconciliation service for patients after discharge from tertiary hospitals to primary care in Singapore: a qualitative study
title_sort pharmacist-led medication reconciliation service for patients after discharge from tertiary hospitals to primary care in singapore: a qualitative study
publishDate 2024
url https://hdl.handle.net/10356/175587
_version_ 1800916381368057856
spelling sg-ntu-dr.10356-1755872024-05-05T15:39:28Z Pharmacist-led medication reconciliation service for patients after discharge from tertiary hospitals to primary care in Singapore: a qualitative study Griva, Konstadina Chua, Zi Yang Lai, Lester Yousheng Xu, Sandra Jialun Bek, Esther Siew Joo Lee, Eng Sing Lee Kong Chian School of Medicine (LKCMedicine) National Healthcare Group Polyclinics Medicine, Health and Life Sciences Medication reconciliation service Medication discrepancies Background: Medication discrepancies commonly occur when patients are transferred between care settings. Despite the presence of medication reconciliation services (MRS), medication discrepancies are still prevalent, which has clinical costs and implications. This study aimed to explore the perspectives of various stakeholders on how the MRS can be optimized in Singapore. Methods: This is a descriptive qualitative study. Semi-structured interviews with 30 participants from the National Healthcare Group, including family physicians (N = 10), pharmacists (N = 10), patients recently discharged from restructured hospitals (N = 7) and their caregivers (N = 3) were conducted. All transcribed interviews were coded independently by three coders and inductive thematic analysis approach was used. Results: Five core themes were identified. (1) The MRS enhanced healthcare services in various aspects including efficiency and health literacy; (2) There were several challenges in delivering the MRS covering processes, technology and training; (3) Issues with suitable patient selection and follow-up; (4) Barriers to scaling up of MRS that involve various stakeholders, cross-sector integration and environmental restrictions; and finally (5) Role definition of the pharmacist to all the stakeholders. Conclusion: This study identified the role of MRS in enhancing healthcare services and explored the challenges encountered in the provision of MRS from family physicians, pharmacists, patients and their caregivers. These findings supported the need for a shift of MRS towards a more comprehensive medication review model. Future improvement work to the MRS can be conducted based on the findings. Nanyang Technological University Published version This project received funding support from National Healthcare Group-Lee Kong Chian School of Medicine, Centre of Primary Health Care Research and Innovation Seedcorn Grant (Project reference code: 004). The funding body was not involved in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript. 2024-04-30T01:09:20Z 2024-04-30T01:09:20Z 2024 Journal Article Griva, K., Chua, Z. Y., Lai, L. Y., Xu, S. J., Bek, E. S. J. & Lee, E. S. (2024). Pharmacist-led medication reconciliation service for patients after discharge from tertiary hospitals to primary care in Singapore: a qualitative study. BMC Health Services Research, 24(1), 357-. https://dx.doi.org/10.1186/s12913-024-10830-6 1472-6963 https://hdl.handle.net/10356/175587 10.1186/s12913-024-10830-6 38509565 2-s2.0-85188255522 1 24 357 en 004 BMC Health Services Research © The Author(s) 2024. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. application/pdf