The findings from a research study supported by a grant from the Pharmacy Practice Research Trust (the Trust) highlight key areas where communication problems occur. These occurred between patients and healthcare professionals; different groups of healthcare professionals such as GPs and pharmacists; and GPs and hospital doctors. The research also found that the root causes of preventable adverse events leading to hospital admission are similar irrespective of whether they are associated with a prescribing, monitoring or patient adherence problem.
Amongst the communication problems identified in the community based study led by Rachel Howard from the School of Pharmacy, University of Reading, UK was insufficient patient counselling about their medicines, the reluctance of patients to ask health professionals about their medicines and an assumption by some community pharmacists that the patient would have received some medicines counselling from their GP. Some patients couldn’t recall the information they’d been given or had difficulty in hearing what was said.
The research also highlighted problems encountered in accessing complex and up to date patient medical and medication records. This affected both GPs working out of hours and community pharmacists contributing to a knowledge gap which in turn led to prescribing and monitoring errors.
“The causes of PDRAs are multifaceted” concluded Rachel Howard. “Technical solutions such as computerised assisted prescribing and the NHS patient care record are unlikely to be sufficient on their own to improve the situation and community pharmacists are hampered by their lack of access to the patient’s medical record. Targeting the human causes, like improving methods of communication, is also necessary.”
In a Foreword to a Trust report of the study, Margaret Dangoor, Executive Director, Association of Litigation and Risk Management writes, “This report makes a valuable contribution to the knowledge base on patient safety and more specifically on preventable medication errors. It’s notable for its setting in primary care, an area that is under researched in terms of medication error and although it includes a relatively small number of incidents, there are lessons to be learnt.”
“The recently published White Paper on Pharmacy in England recommended that chief pharmacists take the lead role in working to reduce unintended hospital admissions related to medicines” said Dr Sue Ambler, Director of the Trust, “and this study is well placed to contribute to this but more studies in the community are needed to identify strategies to help overcome these problems and improve patient outcomes.”
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