Community pharmacy services at the primary-secondary care interface





The primary-secondary care interface provides significant
opportunities for medication errors to arise. There has been
limited research into mechanisms to facilitate seamless transfer
across this interface. The aim of this study was to focus on the potential
contribution of community pharmacy services at the interface.
Materials & Methods:
The opinions of community and hospital
pharmacists were sought in relation to the current situation by means
of questionnaires. A log book of communications between a community
pharmacy and hospitals was maintained. A comparison of new
discharge and post-discharge prescriptions was also performed. The
data was coded and analysed in SPSS v.16.
There is currently little communication across the interface at
the time of discharge, with 11% of community pharmacists reporting
no contact by a hospital at this time and a further 80% stating that they
were only contacted occasionally. Hospital pharmacists reported
ongoing difficulties in attempting to obtain a medication history on admission. Both parties agreed that the introduction of standard
protocols and a designated seamless care pharmacist would improve
medication safety at the interface. Most communication occurred
between the community pharmacy and hospital on a Friday and also
after 3 pm in the evening. When communication did occur the issue
was resolved in 81% of all cases. Medication that required a follow up
prescription from a patient’s family doctor following a hospital
visit was incorrectly transcribed by the family doctor in 27% of cases.
Discussions, Conclusion:
The involvement of community pharmacists
occurs irregularly at present. There is dissatisfaction with the current
situation. Pharmacists at either side of the interface are aware of the
importance of the role that the other plays in seamless care, with both
parties favouring the introduction of processes to facilitate seamless
care at the interface. The involvement of the community pharmacist
in the discharge process, through the dispensing of hospital discharge
prescriptions, helped to reduce the number of medication errors that
could occur at the primary-secondary care interface.

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