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Hospital Pharmacists' opinions on a risk prediction tool for medication-related harm in older people
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  • Ahmed Hussain,
  • Khalid Ali,
  • Graham Davies,
  • Jennifer Stevenson,
  • Samantha Lippett,
  • Mairead O'Malley,
  • Nikesh Parekh,
  • Chakravarthi Rajkumar
Ahmed Hussain
Barts and The London NHS Trust

Corresponding Author:ashussain7@gmail.com

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Khalid Ali
University Hospitals Sussex NHS Foundation Trust
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Graham Davies
King's College London Institute of Pharmaceutical Science
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Jennifer Stevenson
King's College London Institute of Pharmaceutical Science
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Samantha Lippett
University Hospitals Sussex NHS Foundation Trust
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Mairead O'Malley
University Hospitals Sussex NHS Foundation Trust
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Nikesh Parekh
University Hospitals Sussex NHS Foundation Trust
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Chakravarthi Rajkumar
University Hospitals Sussex NHS Foundation Trust
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Abstract

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 eight-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 semi-structured 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’s 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.
30 Apr 2022Submitted to British Journal of Clinical Pharmacology
02 May 2022Submission Checks Completed
02 May 2022Assigned to Editor
04 May 2022Reviewer(s) Assigned
15 Jun 2022Review(s) Completed, Editorial Evaluation Pending
27 Jun 2022Editorial Decision: Revise Major
08 Aug 20221st Revision Received
09 Aug 2022Submission Checks Completed
09 Aug 2022Assigned to Editor
09 Aug 2022Review(s) Completed, Editorial Evaluation Pending
17 Aug 2022Editorial Decision: Accept
15 Sep 2022Published in British Journal of Clinical Pharmacology. 10.1111/bcp.15502