Secondary Hospital Research Articles

Knowledge, attitudes, and current practices toward lung cancer palliative care management in China: a national survey.

The present investigation seeks to illuminate the current state and disparities in the knowledge, attitudes, and practices (KAP) among healthcare professionals regarding the management of lung cancer palliative care (LCPC) in China, while simultaneously assessing the prevalence and context of patient-controlled analgesia (PCA) usage in the management of cancer-related pain. A total of 2093 healthcare practitioners from 706 hospitals across China completed a structured questionnaire that probed various facets of LCPC management. The questionnaire consisted of seven thematic sections, incorporating chi-square tests and Fisher's exact probabilities to statistically assess the discrepancies in KAP among healthcare professionals across different hospital grades. Ordered data distributions among hospital grades were compared using non-parametric Kruskal-Wallis H and Mann-Whitney U tests. Multiple-choice items were subjected to multiple-response cross-tabulation analysis, while the Spearman rank-order correlation coefficient was employed to gauge potential associations among variables. Around 84.2% of the respondents perceived anti-tumor therapy to be of equal importance to palliative care. Statistically significant differences (χ² = 27.402, P = 0.002) in satisfaction levels were observed, with participants from Tertiary hospitals demonstrating higher satisfaction compared to those from Secondary and Primary hospitals. Pain emerged as the most prevalent symptom necessitating LCPC. Major impediments to LCPC adoption included patients' and families' concerns about the safety of long-term palliative care-related drug use. 31.1% of the respondents cited the most frequent rationale for PCA use as cases involving patients who required systemic administration of large opioid doses or exhibited intolerable adverse reactions to opioids. The principal deterrents against the use of PCA for cancer pain management were (1): apprehension about adverse drug reactions due to overdose (2), concern about the potential for opioid addiction, and (3) the anticipated increase in patients' economic burdens. Over the preceding 24-month period, 33.9% of the surveyed healthcare practitioners reported no engagement in either online or offline LCPC-related training initiatives. This study emphasizes the pressing need for comprehensive training in LCPC among Chinese health personnels, particularly focusing on the effective management of cancer pain symptoms.

Outcome of induction of labour at 41 weeks with foley catheter in midwifery-led care

ObjectiveAssess the outcome of induction of labour (IOL) with a Foley catheter in pregnancies at 41 weeks in midwifery-led care setting compared to consultant-led care setting. DesignMixed-methods cohort study at a midwifery – hospital partnership in Amsterdam, the Netherlands. Setting and participantsProspectively, women undergoing IOL in midwifery-led care were recruited at a secondary hospital. This group was compared to a retrospective cohort, in which IOL was exclusively performed under consultant-led care. Measurements and findingsWe compared 320 women whose induction started in midwifery-led care to a historical cohort of 320 women induced for the same reason under consultant-led care. Both groups exhibited similar rates of spontaneous vaginal births (64.2 %vs62.5 %). Caesarean section and assisted vaginal birth rates did not significantly differ. Maternal adverse outcomes were comparable, while neonatal adverse outcomes were significantly higher in the midwifery-led care group (8.1 %vs3.8 %; OR 2.27, 95 % CI 1.12–4.58). The use of pain relief was significantly lower in midwife-led care (65.3 %vs75.3 %; OR 0.62, 95 % CI 0.44–0.87). 20.6 % of births occurred in midwife-led care. Key conclusions and implications for practiceIn this single-centre study, spontaneous vaginal birth rates following IOL with a Foley catheter were similar between midwife- and consultant-led care. However, the midwife-led group showed a higher risk of adverse neonatal outcomes, mainly early onset neonatal sepsis, with a minority eventually delivering under midwife-led care. Implications highlight the need for broader research, validation across diverse settings and exploration of patient and healthcare worker perspectives to refine the evolving midwifery-led care model.

Clinical analysis of 314 patients with high-grade squamous intraepithelial lesion who underwent total hysterectomy directly: a multi-center, retrospective cohort study

ObjectiveTo identify the risk factors of cervical high-grade squamous intraepithelial lesion(HSIL) complicated with occult cervical cancer and standardize the management of initial treatment for HSIL.MethodThe clinical data of patients who underwent total hysterectomy directly due to HSIL in the obstetrics and gynecology department of two tertiary hospitals and three secondary hospitals from 2018 to 2023 were collected. Their general characteristics, pathological parameters and survival status were analyzed. Logistic regression model was used to analyze the correlation between clinical parameters and postoperative pathological upgrading.Result1. Among the 314 patients with HSIL who underwent total hysterectomy directly, 73.2% were from primary hospitals. 2. 25 patients (7.9%) were pathologically upgraded to cervical cancer, all of which were early invasive cancer. 3. Up to now, there was no recurrence or death in the 25 patients with early-stage invasive cancer, and the median follow-up period was 21 months(range 2–59 months). 4. Glandular involvement(OR 3.968; 95%CI 1.244–12.662) and lesion range ≥ 3 quadrants (OR 6.527; 95% CI 1.78–23.931), HPV 16/18 infection (OR 5.382; 95%CI 1.947–14.872), TCT ≥ ASC-H (OR 4.719; 95%CI 1.892–11.766) were independent risk factors that affected the upgrading of postoperative pathology. 5. The area under the curve (AUC) calculated by the Logistic regression model was 0.840, indicating that the predictive value was good.ConclusionThere is a risk of occult cervical cancer in patients with HSIL. Glandular involvement, Lesion range ≥ 3 quadrants, HPV 16/18 infection and TCT ≥ ASC-H are independent risk factors for HSIL combined with occult cervical cancer. The prognosis of biopsy-proved HSIL patients who underwent extrafascial hysterectomy and unexpected early invasive cancer was later identified on specimen may be good.

Attention to STEMI patients in our region: what is the adherence to the quality indicators from a population perspective?

Abstract Funding Acknowledgements None. Introduction The use of quality indicators (QI) proposed by the Association for Acute Cardiovascular Care (ACVC) for processes carried out in cardiology services represents an excellent internal quality control of their operation. Purpose The aim is to assess adherence to the main QI in the care of acute ST-elevation myocardial infarction (STEMI) in our region, according to data from the population-based registry of myocardial infarction in that area. Methods Evaluation of adherence to the main QI proposed by the ESC Association for ACVC, by retrospective analysis (data from in-hospital and out-of-hospital care) of patients with STEMI from our regional Infarction Registry attended between 2017 and 2020, in both tertiary and secondary hospitals of the public and private care network, providing data with a population-based character. Results QI were analysed in 1355 patients categorised as STEMI in our regional Infarction Registry between 2017 and 2020. 71% of patients were male. The number of STEMI per year ranged from 358 in 2019 to 316 in 2020. Primary percutaneous coronary intervention (PCI) was performed in 87% of patients. In 53% the first medical contact occurs in out-of-hospital care, while 25% occur in emergency departments (ED) of PCI capable hospitals and 12% in emergency departments of non-PCI hospitals. Forty-two percent of patients firstly attended out-of-hospital or in non-PCI centres achieve revascularisation in less than 90 minutes, but less than 30% of patients seen in PCI centres achieve revascularisation in less than 60 minutes. Radial access was used in 92% of cases. LVEF was assessed during admission in 98% and LDL-cholesterol was determined in 87%. Ninety-one per cent of patients were discharged on dual antiplatelet therapy, 96% on statins and a large proportion of patients with left ventricular dysfunction received angiotensin-converting enzyme inhibitors (78%) and beta-blockers (88%). Conclusion There is good overall adherence to major QI related to care of patients with STEMI in our region. However, there are indicators that could be optimised, particularly those related to timely primary reperfusion. Networked care thanks to the local Infarction Code means a significant reduction in reperfusion times, avoiding unnecessary referrals to Emergency Departments.

Trends in the mobility of primary healthcare human resources in underdeveloped regions of western China from 2000 to 2021: Evidence from Nanning

ObjectiveThis research aimed to identify the fundamental and geographic characteristics of the primary healthcare personnel mobility in Nanning from 2000 to 2021 and clarify the determinants that affect their transition to non-primary healthcare institutions.MethodsThrough utilizing the Primary Healthcare Personnel Database (PHPD) for 2000–2021, the study conducts descriptive statistical analysis on demographic, economic, and professional aspects of healthcare personnel mobility across healthcare reform phases. Geographic Information Systems (QGIS) were used to map mobility patterns, and R software was employed to calculate spatial autocorrelation (Moran’s I). Logistic regression identified factors that influenced the transition to non-primary institutions.ResultsPrimary healthcare personnel mobility is divided into four phases: initial (2000–2008), turning point (2009–2011), rapid development (2012–2020), and decline (2021). The rapid development stage saw increased mobility with no spatial clustering in inflow and outflow. From 2016 to 2020, primary healthcare worker mobility reached its peak, in which the most significant movement occurred between township health centers and other institutions. Aside from their transition to primary medical institutions, the primary movement of grassroots health personnel predominantly directs towards secondary general hospitals, tertiary general hospitals, and secondary specialized hospitals. Since 2012, the number and mobility distance of primary healthcare workers have become noticeably larger and remained at a higher level from 2016 to 2020. The main migration of primary healthcare personnel occurred in their districts (counties). Key transition factors include gender, education, ethnicity, professional category, general practice registration, and administrative division.ConclusionsThis study provides evidence of the features of primary healthcare personnel mobility in the less developed western regions of China, in which Nanning was taken as a case study. It uncovers the factors that impact the flow of primary healthcare personnel to non-primary healthcare institutions. These findings are helpful to policy refinement and support the retention of primary healthcare workers.

Understanding referral of patients with cancer in rural Ethiopia: a qualitative study

BackgroundCancer incidence is increasing in Ethiopia mainly due to increased life expectancy, while oncological capacities remain limited. Strong referral linkages between different levels of the healthcare system are key to provide timely access to cancer care. In this qualitative study, we assessed limitations and potential of cancer patient referral in the rural Southwest of Ethiopia.MethodsWe held four focus group discussions (FGD) with health professionals at one primary and three secondary hospitals and conducted eight in-depth interviews (IDI) with the hospitals´ medical executives and local health bureau representatives. Data was analysed inductively using thematic analysis and emerging themes were categorized within the revised concept of access by Penchansky and Saurman.ResultsThe inevitable referral of patients with cancer in the rural Southwest of Ethiopia is characterized by the absence of clear communication protocols and the lack of formal referral linkages. The newly implemented hub-system has improved emergency referrals and could be expanded to non-emergency referrals, sensitive to the needs of advanced oncological care. Liaison officers can pave the way but need to be trained and equipped adequately. Referred patients struggle with inadequate transportation systems, the lack of accommodation close to specialized facilities as well as the inability to navigate at those sites due to language barriers, illiteracy, and stigmatization. Few Non-Governmental Organizations (NGOs) help but cannot compensate the limited governmental support. The shortage of medications at public hospitals leads to patients being directed to costly private pharmacies. In the light of those challenges, cancer remains to be perceived as a “death sentence” within the rural communities.ConclusionsStandardized referral linkages and a multi-faceted support network throughout the cancer care continuum are necessary to make oncology care accessible to Ethiopia´s large rural population.

Multicenter Investigation of Drug-Resistance in Burkholderia Cepacia Bloodstream Infections in Hebei Province, China, from 2016 to 2021.

To compare the epidemiological characteristics and drug resistance of Burkholderia cepacia isolated from blood cultures, and to provide data support and a scientific basis for the clinical treatment and detection of hospital infections. The Hebei Province Antimicrobial Surveillance Network received 349 B. cepacia strains isolated from blood cultures reported by 83 hospitals, from 2016 to 2021. These strains were identified by MALDI-TOF MS and, the antibiotic sensitivity tests were carried out using the VITEK 2 COMPACT system. The 2023 Institute of Clinical and Laboratory Standardization drug-susceptibility breakpoints were used for drug susceptibility testing and the data were analyzed using WHONET5.6 software. A total of 349 B. cepacia strains were isolated from 2016 to 2021, including 68 strains from secondary hospitals and 281 strains from tertiary hospitals. The ratios of male: female patients with B. cepacia bloodstream infections in all hospitals, secondary hospitals, and tertiary hospitals were 1.49:1 (209/140), 2.09:1 (46/22), and 1.38:1 (163/118), respectively. Most B. cepacia strains were isolated in intensive care units (ICUs), followed by internal medicine departments, accounting for 49.57% (173/349) and 22.92% (80/349), respectively. Regarding the age distribution, most patients were elderly (>65 years, 57.59%, 201/349), with numbers of patients gradually declining with decreasing of age. The resistance rates for levofloxacin, ceftazidime, and sulfamethoxazole decreased over the 6-year period (P<0.05), while there were no significant changes in the resistance rates for meropenem, chloramphenicol, and minocycline (P>0.05). There was no significant difference in drug-resistance rates between secondary and tertiary hospitals (P>0.05). Attention should be paid to bloodstream infections caused by B. cepacia, especially elderly patients and patients admitted to the ICU. The difficult treatment characteristics of B. cepacia bloodstream infections mean that laboratories and clinicians should pay careful attention to drug resistance to provide a basis for their prevention and empirical treatment.

Paediatric off-label use of drugs in Gansu, China: a multicentre cross-sectional study

ObjectiveTo examine the current prevalence and cost of paediatric off-label drug prescriptions in Gansu, China, and the potential influencing factors.DesignThe prevalence of off-label prescriptions in paediatrics was evaluated according to...

Evaluation of drug related problems among hospitalised elderly patients at a secondary hospital in East Borneo

Background: The elderly population often requires increased drug intake (polypharmacy) due to diminished organ function, particularly in the liver and kidneys, responsible for processing medications. Identifying drug-related problems (DRPs) in this demographic is crucial for mitigating morbidity, mortality, and overall drug therapy costs. Objective: This study aimed to identify DRPs and their determinants in hospitalised geriatric patients. Methods: An observational retrospective study was conducted in the Secondary Hospital in East Borneo from January 2019 - December 2021. Data were collected from medication charts, including patients aged 60-79, medical progress notes, and laboratories. DRPs were identified and classified using Pharmaceutical Care Network Europe’s (PCNE) classification V9.0. Results: Of the 614 included patients, 79% were aged 60-69 years, 56.0% were male, and 73% were prescribed ≥ five medications. DRPs were identified in 75.2% of patients, primarily related to treatment effectiveness (27.19%) and treatment safety (53.42%). Causes included inappropriate monitoring (14.5%), improper drug combinations (51.79%), excessive drug dosage (16.61%), and inadequate drug dosage (13.51%). Conclusion: The high frequency of DRPs, specifically concerning treatment effectiveness and safety, highlights the need for enhanced monitoring and prescribing procedures, contributing to preventing and treating future DRPs in the elderly population.

Infection control practices in public sector hospitals of Punjab: a critical analysis

IntroductionInfection prevention and control (IPC) is imperative towards patient safety and health. The Infection Prevention and Control Assessment Framework (IPCAF) developed by WHO provides a baseline assessment at the acute...

Prevalence of salmonella infection among the suspected enteric fever patients conducted at secondary hospital, Kathmandu, Nepal

Prevalence of salmonella infection among the suspected enteric fever patients conducted at secondary hospital, Kathmandu, Nepal

Analysis of cost of illness and diagnosis-related group payment system in breast cancer patients with chemotherapy in Indonesia

Background: Often, breast cancer patients undergoing chemotherapy sacrifice their finances, and the financial costs also affect the government. Objective: This study aims to analyse the cost of illness and the application of an insurance payment system among breast cancer patients receiving various chemotherapy regimens. Method: This study was retrospective and used a bottom-up prevalence approach. Data were collected from a secondary hospital between 2020 and 2021. The inclusion criteria were breast cancer patients undergoing chemotherapy. Patients with incomplete detailed cost data were excluded. The cost of illness was calculated from direct medical costs and the estimated non-medical and indirect costs. Results: The cost of illness for a chemotherapy visit for a breast cancer patient spanned from USD 130.37 to USD 932.05. However, these values did not include healthcare service costs and laboratory tests. The highest regimentation chemotherapy cost is for the combination of docetaxel–cyclophosphamide–trastuzumab. There was a significant margin between insurance claims and variable medical costs (p &lt; 0,05), ranging between USD 24.21 and 104.83. Conclusion: The cost of illness for chemotherapy for breast cancer patients is high, and the coverage of the diagnosis-related payment system is limited. Therefore, the government should accelerate prevention programmes to reduce the incidence of cancer.

Implementation and execution of integrated point of care testing program in three secondary hospitals across Karachi-a lean management approach

Implementation and execution of integrated point of care testing program in three secondary hospitals across Karachi-a lean management approach

Socioeconomic Factors Including Patient Income, Education Level, and Health Insurance Influence Postoperative Secondary Surgery and Hospitalization Rates Following Hip Arthroscopy

To evaluate a large cross-sectional sample of patients utilizing administrative database records and analyze the effects of income, insurance type, and education level on outcomes after hip arthroscopy, including 2-year revision surgery, conversion to total hip arthroplasty (THA), and 90-day hospitalizations. Current Procedural Terminology codes were used to query the PearlDiver Mariner database from October 2015 to January 2020 for patients undergoing hip arthroscopy with a minimum 2-year follow-up. Patients were categorized by mean family income in their zip code of residence (MFIR), health insurance type, and educational attainment in their zip code of residence (EAR). Two-year revision arthroscopy, conversion to THA, and 90-day hospital readmissions or emergency department (ED) visits were analyzed along socioeconomic strata. Multivariate analysis of 33,326 patients revealed that patients with MFIR between $30,000 and $70,000 had lower odds of 2-year revision arthroscopy (odds ratio [OR], 0.63; P < .001), THA conversion (OR, 0.76; P= .050), and 90-day readmission (OR, 0.53; P= .007) compared to MFIR >$100,000. Compared to patients with commercial insurance, patients with Medicare had lower odds of revision arthroscopy (OR, 0.60; P=.035) and THA conversion (OR, 0.46, P < .001) but greater odds of 90-day readmission (OR, 1.74; P= .007). Patients with Medicaid had higher odds of 90-day ED visits (OR, 1.84; P < .001). Patients with low EAR had higher odds of revision arthroscopy (OR, 1.42; P= .005) and THA conversion (OR, 1.58; P= .002) compared to those with high EAR. Following hip arthroscopy, patients residing in areas with lower mean family income were less likely to undergo reoperations and readmissions. Medicare patients showed lower reoperation but higher readmission odds, whileMedicaid patients showed higher odds of ED visits. Additionally, higher educational attainment in the zip code of residence is protective against future reoperation. Level III, retrospective case series.

What are the experiences of teleophthalmology in optometric referral pathways? A qualitative interview study with patients and clinicians

ObjectiveImplementing teleophthalmology into the optometric referral pathway may ease the current pressures on hospital eye services caused by over-referrals from some optometrists. This study aimed to understand the practical implications...

Model Development of Telemedicine for Hypertension Patients in a Rural Primary Healthcare Center in Thailand: A Qualitative Study

Background: Hypertension services were disrupted by the COVID-19 pandemic. Telemedicine was heavily used to overcome this disruption. The aims of this study were to describe a typical hypertension service and recommendations for telemedicine development for hypertension patients in a rural, Sub-District-level, primary healthcare center.Methods: A qualitative case study was utilized. In-depth interviews were conducted with healthcare staff at a rural primary healthcare center in April 2023. The interview process was continued until data saturation had been achieved. Data from the interviews were assessed via the triangulation method. Analytic induction was used to analyze the data.Conclusion: The total number of participants was 10 persons (3 male and 7 female). The median age was 42 years old (min. 32, max. 58). The qualitative results revealed that participants believed that telemedicine provided adequate hypertension services. The patients’ data was sent from the primary healthcare center to the secondary hospital (Provincial level) via the internet system. Communications between the patients and doctors at the provincial hospital were executed via video calls. All services were performed and completed at the primary healthcare center. The use of telemedicine by Sub-District healthcare hospitals could mitigate the limitations of traditional care, such as the lack of physicians, delays in treatment, and limited medical equipment. The engagement of stakeholders was the key factor in the success and sustainability of the program.

Nonunion After First Metatarsophalangeal Joint Arthrodesis: The Association With Shoe Size.

First metatarsophalangeal joint (MTPJ) arthrodesis is a common treatment for various foot conditions, with nonunion as a frequent complication. The incidence of nonunion varies widely in the literature. In particular, males have a higher risk of nonunion than females.This is possibly due to biomechanical and anatomical differences, as men have on average larger feet than women. This study therefore aims to explore whether shoe size, as a proxy for foot size, affects nonunion rates and could explain the gender disparity in nonunion rates. An exploratory analysis of retrospectively collected data from patients who underwent primary first MTPJ arthrodesis in a single secondary hospital between January 2012 and December 2019. Additional data on body weight, height, and shoe size were prospectively collected from patients. Among 261 included patients, 57 (21.8%) experienced nonunion. Nonunion incidence was higher in males (18, 26.9%) than in females (39, 20.1%). Self-reported shoe size showed no significant association with nonunion in both univariate and multivariate analyses. The study's findings suggest that shoe size, as a proxy for foot size, is not associated with nonunion after the first MTPJ arthrodesis. Despite observing a gender difference in nonunion rates, this disparity could not be explained by shoe size. Shoe size as a proxy for foot size appears to have no clinical association with nonunion following the first MTPJ arthrodesis.

Comparison of fidaxomicin, metronidazole and vancomycin for initial episode and recurrence of Clostridioides difficile infection - An observational cohort study

ObjectivesThe main aim of this study was to compare the clinical outcomes of patients attended in our area with Clostridioides difficile infection (CDI) (sustained cure, recurrence or death) in relation to treatment to normal or hypervirulent C. difficile as a risk factor and to describe the resistance profile to metronidazole and vancomycin antibiotics in our hospital over a one-year period. MethodsA retrospective, cross-sectional and observational study was conducted between June 2022 and June 2023 to compare the clinical cure and/or recurrence of CDI in adult patients treated in a Spanish secondary Hospital depending on the prescribed antibiotic treatment. In addition, we performed an antimicrobial susceptibility study to vancomycin and metronidazole in all C. difficile isolated in bacterial culture. ResultsOut of 194 selected patients the treatments were as follow: 43.81 % vancomycin, 21.65 % metronidazole, 8.25 % a combination of both, 6.70 % fidaxomicin and 19.59 % were untreated. Vancomycin and fidaxomicin patients had higher odds ratio of prolonged hospitalization (p = 0.041 and p = 0.040, respectively). Fidaxomicin had increased odds of suffering another episode of C. difficile (p = 0.009) and it was inferior to metronidazole for recurrent CDI (rCDI) (p = 0.035).Resistance profile for C. difficile was 4.07 % for vancomycin and 3.49 % for metronidazole. Hypervirulent C. difficile was identified in 17 (8.76 %) patients with 29.41 % of mortality (5/17; p > 0.05). ConclusionFidaxomicin treated patients had statistically increased odds of rCDI. Compared to other treatments, fidaxomicin was inferior to metronidazole for rCDI in our cohort;Hypervirulent C. difficile was not associated with death.Vancomycin resistance of C. difficile statistically decreased, whereas metronidazole resistance did not vary during the studied period.

Spatial distribution of pediatric cancer patients using Geographic Information System (GIS) across the Philippines

Background: Every year, many children around the world get cancer, and this is a severe health problem. The Philippines is one such country where childhood cancer is a leading cause of death. This study uses unique maps (Geographic Information Systems or GIS) to examine these young cancer patients' locations. By doing this, we hope to find areas with more cases and see if children in those areas have easy access to the medical care they need. Methods: Methods involved primary and secondary data collection, including surveys and hospital records, with geospatial data analyzed using QGIS 3.4 Madeira. The study focuses on four Department of Health (DOH) tertiary hospitals: Philippine Children Medical Center (PCMC), Bicol Regional Training and Training Hospital (BRTTH), Southern Philippines Medical Center (SPMC), and Vicente Sotto Memorial Medical Center (VMMC) Participants from significant regions contributed to the study. Results: Results indicate that cancer centers, notably the primary children’s hospital, cater to patients from far-reaching areas, causing them to consult distant hospitals despite accessible alternatives. Nearly all (around 92.5%) patients seek care at specialized hospitals, even though only a small proportion (roughly 12.3%) live close to such facilities. Instead, 37.3% reported the closest health facility (within 10 kilometers) is a secondary government hospital, increasing the burden on patients with additional travel and non-medical costs. Conclusions: The study concludes that pediatric cancer patients face challenges accessing healthcare facilities, necessitating alternative methods like telemedicine and mobile clinics. The findings underscore the need for improved healthcare infrastructure and human resources to address the burdens faced by these patients.

Community pharmacy discharge medicines service activity as recorded in PharmOutcomes: a retrospective exploration and analysis.

Transition of care when a patient moves between healthcare locations is a risk factor for medication errors and medicines-related preventable harm. The aims of this retrospective service evaluation were to understand, by classifying and quantifying, the nature of interventions made by community pharmacy when receiving a discharge medicines service referral from a secondary care hospital, with a focus on two groups of high-risk medicines supplied at discharge-oral anticoagulants and weak opioids following hip or knee surgery. Records made on the PharmOutcomes™ platform by community pharmacists in response to referral for the NHS England discharge medicines service were analysed and summarized. This analysis was exploratory and interpretative in nature and used a convenience sample of patients who had consented for the service over 12 months from May 2022 to April 2023. During 12 months, 6811 referrals occurred, of which 71% were recorded as having different stages of the service completed on PharmOutcomes™. Medicines reconciliation, first-prescription review, and consultation stages decreased as patients progressed through the service. Slightly greater rates of completion were observed for patients receiving oral anticoagulants and for codeine or dihydrocodeine following hip and knee surgery, although overall referrals were low for this latter cohort. Through this service, community pharmacists are well placed to support the safe and effective use of medicines including oral anticoagulants and weak opioids posthospital discharge and potentially reduce incidents of avoidable harm. The variations in recorded completion rates across the three stages of the service and the apparent greater finalization rates for the high-risk medicines studied require further investigation.