Poor communication causes hospital admissions
Communication problems and lack of knowledge about a patient’s medication or medical history are the main causes of preventable drug-related admissions to hospital, research suggests.
The research also indicates that community pharmacists sometimes think
that giving advice about prescribed medicines is not their job. Others
wrongly assume that GPs discuss medication with patients so fail to raise
the issue when they dispense a prescription.
The research, published in Quality and Safety in Health Care (2008;17:109), involved
18 patients, eight informal carers, 17 GPs, 12 community pharmacists, three practice
nurses and four other healthcare staff. All the patients were admitted to a Nottingham
teaching hospital between 1 January and 31 December 2004.
The community pharmacists reported that they were reluctant to challenge a patient’s
prescription — even if they thought it might be harmful — because
they had insufficient information about a patient’s medical and medication
history, according to the study led by Rachel Howard from the University of Reading
school of pharmacy.
GPs also had problems accessing complex electronic patient records and failure
to update patient records after a home visit made the problem worse. Computer
systems sometimes let down GPs and pharmacists because the drug interaction alert
system was inefficient, which meant clinical screening of prescriptions was difficult.
The researchers recommend that community pharmacists receive extra training to
make sure they can use the computerised NHS patient care record to help reduce
preventable drug-related admissions to hospital in the future.
Training to improve communication between prescribers and pharmacists is also
necessary so that pharmacists find it easier to challenge potential problems
in prescriptions.
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