E.S.LEE1, S.J.L. XU2, E.S.J.BEK2, N.D.SHAFIE1, Z.Y.CHUA3, K.GRIVA4
NHG Polyclinics1, NHG Pharmacy2, National Cancer Centre Singapore3, Nanyang Technological University4
Medication discrepancies during transition of care is pertinent for patient safety but still occur frequently. The aim of this study was to co-develop a Medication Review Service (MRS) with all stakeholders in the community.
A mixed-methods study including individual in-depth interviews (IDI), online survey and a focus group discussion (FGD) were conducted sequentially with the results of each stage analysed and informing the questions and topic guide for the next stage. IDIs were conducted face-to-face with healthcare professionals, patients and caregivers. TypeformTM online platform was used to gather opinions from pharmacists on the existing medication reconciliation service. Finally, a FGD was conducted over a web-based videoconferencing platform with various stakeholders including healthcare providers, patient advocate, patient and participants from Ministry of Health and Chief Pharmacist Office. An inductive thematic analysis approach was used for the qualitative studies. Descriptive statistical analysis was performed for the online survey using SPSS.
IDIs were conducted with 30 participants. Forty-seven primary care pharmacists participated in the online survey and 11 participants attended the FGD. The three themes that emerged were (1) selecting suitable patients for MRS more systematically, (2) including patient-centredness, patient empowerment and agency in the MRS consultation framework, and (3) leveraging on technology for education, information retention and follow-up.
Our mixed-methods study found three emergent themes that could be implemented immediately in the primary care setting to reduce medical discrepancies during transition of care. Moving forward, a pilot study based on the MRS would be conducted to determine its acceptability, feasibility and sustainability.