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Hospital pharmacists' opinions on a risk prediction tool for medication‐related harm in older people
Author(s) -
Hussain Ahmed,
Ali Khalid,
Davies J. Graham,
Stevenson Jennifer M.,
Lippett Samantha,
O'Malley Mairead,
Parekh Nikesh,
Rajkumar Chakravarthi
Publication year - 2023
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.15502
Subject(s) - medicine , psychological intervention , multidisciplinary approach , clinical pharmacy , harm , family medicine , qualitative research , emergency medicine , medical emergency , pharmacy , nursing , psychology , social psychology , social science , sociology
Aim Older adults are particularly affected by medication‐related harm (MRH) during transitions of care. There are no clinical tools predicting those at highest risk of MRH post hospital discharge. The PRIME study (prospective study to develop a model to stratify the risk of MRH in hospitalized patients) developed and internally validated a risk‐prediction tool (RPT) that provides a percentage score of MRH in adults over 65 in the 8 weeks following hospital discharge. This qualitative study aimed to explore the views of hospital pharmacists around enablers and barriers to clinical implementation of the PRIME‐RPT. Methods Ten hospital pharmacists: (band 6, n = 3; band 7, n = 2; band 8, n = 5) participated in semistructured interviews at the Royal Sussex County Hospital (Brighton, UK). The pharmacists were presented with five case‐vignettes each with a calculated PRIME‐RPT score to help guide discussion. Case‐vignettes were designed to be representative of common clinical encounters. Data were thematically analysed using a “framework” approach. Results Seven themes emerged in relation to the PRIME‐RPT: (1) providing a medicine‐prioritisation aide; (2) acting as a deprescribing alert; (3) facilitating a holistic review of patient medication management; (4) simplifying communication of MRH to patients and the multidisciplinary team; (5) streamlining community follow‐up and integration of risk discussion into clinical practice; (6) identifying barriers for the RPTs integration in clinical practice; and (7) acknowledging its limitations. Conclusion Hospital pharmacists found the PRIME‐RPT beneficial in identifying older patients at high risk of MRH following hospital discharge, facilitating prioritising interventions to those at highest risk while still acknowledging its limitations.