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Evaluation and Comparison of Pharmacist and Physician Written Referrals Within the MedBridge study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
2019 (English)Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
Abstract [en]

Introduction: In conjunction with the transition of care (TOC) process between different health care providers, important information about the patients’ medication can disappear. This can result in, for example, adverse drug events (ADEs). In this case, the communication between the hospital and primary care providers is highly prioritized. Physicians and clinical pharmacists sending medication-related referrals (MRRs) at the time of patient discharge could be one strategy to bridge the gap. These MRRs contain proposed actions (PAs). Patients are included into one of three groups; two groups where a pharmacist is involved (I1 and I2), or a control group (C), without any pharmacist.

Aim: To evaluate and compare the number of patients for whom an MRR was sent at discharge from the index admission at group and hospital level, within the MedBridge study. This in order to determine if MRRs influence patient care after discharge.

Material and Methods: The population used in this study were all patients included in the MedBridge study. All MRRs and accompanying PAs from physician and pharmacists at index admission were analysed and evaluated by reviewing the patients’ electronic health records from the hospital admissions and from primary care. 

Results: At group level, there was no significant difference between the groups with a pharmacist involved (I1 and I2) compared to C regarding the number of patients receiving an MRR. At hospital level, there was a significance difference (the p-value was 0.02) only for the hospital of Enköping where an MRR was sent for 195 (43%) patients in I1 and I2, versus 73 (33%) in the control group. In total, there were 56,5% patients who did not receive an MRR. Among those who did receive an MRR at the two more extensively studied hospitals of Uppsala and Enköping, 72% of the accompanying PAs in I1 and I2 were acted upon in primary care versus 76% in C.

Conclusions: Except for the hospital of Enköping, where there was a higher number of patients receiving an MRR in I1 and I2 compared to C, there was no difference in the number of patients receiving an MRR in either group- or hospital level between all four hospitals. However, considering that over 70% of all PAs were acted upon in primary care, it appears to be of great importance to send MRRs.

Place, publisher, year, edition, pages
2019. , p. 24
Keywords [en]
clinical pharmacy, referrals, primary care, MedBridge
Keywords [sv]
klinisk farmaci, remisser, primärvård, MedBridge
National Category
Pharmaceutical Sciences
Identifiers
URN: urn:nbn:se:uu:diva-390450OAI: oai:DiVA.org:uu-390450DiVA, id: diva2:1341729
External cooperation
Uppsala University Hospital
Subject / course
Pharmacotherapy
Educational program
Master of Science Programme in Pharmacy
Supervisors
Examiners
Projects
MedBridgeAvailable from: 2019-08-13 Created: 2019-08-10 Last updated: 2019-08-13Bibliographically approved

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