Pharmacy staff views on the implementation of patient handheld medication tools to improve information transfer: a qualitative study

Abstract

The risks of poor information transfer across healthcare settings are well documented, particularly for medication. Various patient-held tools have been designed to hold information about patients’ medicines to improve information transfer. Anecdotal evidence suggests some are more widely implemented than others, but there has been little research exploring the reasons why. Our objectives were to explore the facilitators and barriers to implementation of patient handheld medication information from the perspective of pharmacy staff, to understand why some tools are more widely implemented than others and to make recommendations as appropriate. Semi-structured interviews were conducted with 15 pharmacists and pharmacy technicians working in wards and/or dispensary of a London hospital organisation. Participants were recruited using convenience sampling. We asked about six purposefully selected tools designed to be carried by patients to provide information about their medicines, including both national and local tools, and those that were new and established. Interviews were audio-recorded and transcribed verbatim. We used framework analysis, based on a theory of behavioural change. The majority of participants expressed the view that older tools, such as the steroid card and warfarin booklet, were used more often than newer tools such as a medication passport and a specific insulin passport. Interview data suggested that pharmacy staff did not have enough information and training about the proper use of the newer tools and therefore lacked confidence in providing them to their patients. In addition, they perceived that they were not integrated into policies and procedures with a lack of guidance regarding their use. We identified the main barriers to effective implementation of tools to increase patient safety across healthcare settings to be lack of guidance and training for newer tools. Making a tool available is not sufficient to ensure its use. Recommendations include clarifying guidance within the hospital organisation to standardise use of all tools and raising awareness and providing training to both healthcare professionals and patients about their use.