The discharge medicines review service in Wales: a mixed methods evaluation

James, Robert 2022. The discharge medicines review service in Wales: a mixed methods evaluation. PhD Thesis, Cardiff University. Item availability restricted.

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Abstract

The World Health Organization aimed to halve medicines-related harm by 2022. The all-Wales Discharge Medicines Review (DMR), a community pharmacist (CP) service, aims to reduce these risks for patients discharged from any care setting. To improve CP access to the discharge medicines information needed to complete a DMR, the DMR referral system (DMRRS) was developed to provide electronic access. The DMRRS provides CP with access to this electronic information if the patient was either pre-registered for the DMR service or referred from the hospital. Despite the evidence supporting the role of the DMR in patient safety, its uptake is limited. Therefore, this thesis used mixed methods to develop recommendations to optimise the DMR's use by integrating the results of five studies. Study one undertook a literature review and key informant interviews, contrasting the DMRRS with similar technologies in England to highlight areas of good practice. Study two undertook sixteen focus groups to explore hospital pharmacy professionals' engagement with the DMR service. Studies 3-5 involved secondary analysis of all ten years of DMR consultation data to describe the provision of the service and factors affecting its delivery and outcomes. The integrated findings highlighted low awareness of the DMR, its benefits and processes. Additionally, the results suggest limited collaboration between care settings and inconsistency uptake of the DMR service. Further work must investigate this inconsistent uptake by exploring CPs' views of the service. Considerable investment in IT is required to optimise the DMRRS to improve engagement with it, and to complete its implementation. Furthermore, cross-sector collaboration and promotion of the DMR are required to increase awareness and buy-in. The results show that the DMR identifies issues that could lead to harm. Therefore, the recommendations developed from this thesis should be adopted to optimise the use of the DMR, ensuring its patient safety benefits are realised.

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Pharmacy
Subjects:	Q Science > Q Science (General)
Date of First Compliant Deposit:	20 March 2023
Last Modified:	26 Jul 2023 10:52
URI:	https://orca.cardiff.ac.uk/id/eprint/157810

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