Pharmacist-patient medication communication during admission and discharge in specialty hospital settings: implications for person centered healthcare

Abstract

Background Hospital admission and discharge are critical transition points for patients’ medication management. Effective communication between pharmacists and patients at these transition points has the potential to mitigate medication incidents. Previous research has examined communication among community pharmacists and patients. Limited research has explored the complexities of communication between hospital pharmacists and patients during admission and discharge interactions.Objective To explore the complexities of pharmacist-patient medication communication during medication admission and discharge in specialty hospital settings.Methods The study was conducted at a metropolitan Australian public hospital. An exploratory qualitative design was used involving the methods of semi-structured interviews and participant observation. Interviews and observations were undertaken in five specialty settings: cardiothoracic care, intensive care, emergency care, oncology care and perioperative care. A comprehensive thematic analysis of the data was performed.Results Twelve pharmacists and 69 patients participated in interviews and observations for the study. Over 200 hours of observational data were collected. In total, 26 medication admissions and 35 medication discharges were observed. Pharmacists regulated communication with patients by using structured communication tools. When providing or gathering information, pharmacists controlled the level of patient engagement. Words used in pharmacist-patient communication were sometimes ambiguous and occasionally miscommunication resulted. Patients sought minimal information from pharmacists.Conclusions Pharmacists need to apply patient-centered principles, and encourage active patient involvement, in admission and discharge conversations.