Two clinical pharmacists and a consultant physician in elderly medicine further reviewed recruited patients’ hospital admission notes to validate MRHA cases identified1. The RP conducted semi-structured face-to-face interviews
with patients prior to discharge and reviewed respective patients’ health records held at thirteen General Practitioner (GP) surgeries. Information from hospital admission notes were compiled on a data collection form by the RP including: patients’ demography; social, medical and medication history; presenting complaints; examination/test results; preliminary/confirmed diagnosis; management plan. Patients were interviewed using the MRP screening tool which is intended to identify MRPs from the patient’s see more perspective2. This allowed a retrospective review Nutlin-3a mw of patient’s medicines management and use of healthcare services. Written records were maintained for all interview responses. Patients’ GP records were reviewed to examine information
related to medical history, recent consultations and medication history for up to 6 months prior to hospital admission. Patient notes review by clinical pharmacists and physician, patient interviews and GP records reviews were undertaken to identify and/or substantiate any MRPs already identified by the RP. SPSS version 20 enabled quantitative data analysis while conceptual content analysis was undertaken to analyse qualitative data. Ethics approval was obtained from the NHS Essex 2 REC. Informed consent for participation in interviews and GP records review was sought and obtained. A total of 79 cases (out of 1,047 reviewed) were identified as MRHAs following initial hospital notes review; 15 patients were recruited to the study. The mean and median age of patients was 83.4 and 85 years respectively; 80% (n = 12) were female. All patients
were of White ethnic origin and lived at home with no formal care. Patients had an average of 5 (SD = 2.9) co-morbidities and were taking an average of 11 (SD = 3.4) medicines prior to hospital admission. Causes of MRHAs included adverse drug reactions and drug therapeutic failures. Kappa statistical results for the validation of MRHA cases by the clinical pharmacists Adenosine and physician indicated an inter-rater reliability range of moderate to very good agreement (0.5–1). Patients’ accounts described difficulties with healthcare delivery and medicines management. The reported role of the pharmacist was limited and GPs were often indicated as the healthcare professional to contact to resolve MRPs in primary care. Patients reported issues with booking appointments and displeasure with the lack of provision of healthcare by one specified GP. Patients frequently consulted their GP in the months leading up to the hospital admission under review.