An investigation of the opinions of community and hospital pharmacists and general practitioners of the management of drug therapy at the primary-secondary care interface





Drug-related problems and medication errors, many
preventable, are known to make a significant contribution to morbidity
and mortality. The point of transfer between primacy and
secondary care provides significant opportunities for medication
errors to arise, especially in the absence of structured transfer protocols.
There has been limited national and international research into
mechanisms to facilitate seamless transfer across the primary-secondary
care interface. This study attempts to identify the current
arrangements that are in place and the opinions of healthcare professionals
of those arrangements.
Materials & Methods:
The opinions of community pharmacists,
hospital pharmacists and general practitioners in relation to the current
procedures in place for the admission and discharge of patients,
with particular reference to drug therapy, were sought. This was done
by means of self-administered, anonymous, postal questionnaires
which were distributed nationwide. The data were coded and analysed
in SPSS v. 16. Standard statistical parameters were calculated and
statistically significant relationships were determined using ANOVA
and the chi-squared test where appropriate, taking p<0.05 to be significant.
There is currently very little communication across the
interface at the time of discharge, with 10.7% of community pharmacists
reporting that they have never been contacted by a hospital to
inform them of the imminent discharge of a patient, with a further
79.8% stating that they were only contacted occasionally. On the
other side of the interface, hospital pharmacists reported ongoing
difficulties in attempting to obtain a patient medication history on
admission, with 75.5% of respondents stating that they regularly,
often or always encountered these difficulties.
Discussions, Conclusion:
The majority of community and hospital
pharmacists and general practitioners were dissatisfied with the
management of drug therapy during the hospital discharge process.
All three groups of healthcare professionals felt that the introduction
of a structured seamless care programme linking hospitals, general
practitioners and community pharmacists to be important or very
important. It is intended that the results of this analysis will feed into a
protocol for a pilot seamless care programme based in the community

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