Exploring communications around medication review in community pharmacy

Abstract

Objectives: Investigation into aspects that influence outcomes of medication reviews have been called for. The aim of this study was to assess how pharmacy internship students in a Danish medication review and reconciliation model communicated with both diabetes patients and the patients' General Practitioners (GPs) when conveying the results of the review by writing letters to the different parties. Special attention was drawn to how differences in health care provider and patient perspectives of the disease as well as inclusion of the patient in the decision making process is influenced by the identified practices of communication.

Setting: 18 Danish community pharmacies with The Department of Pharmacology and Pharmacotherapy at the Faculty of Pharmaceutical Sciences, University of Copenhagen.

Method: Number of identified drug related problems, life-world problems and solutions to these described in the letters sent to patients and their GPs were registered. Further a qualitative documentary analysis was conducted by analyzing the letters using the theory of transactional analysis, developed by Berne.

Main outcome measures: Identified and conveyed drug related and life-world related problems when comparing patients' letters with GPs' letters. Whether students assumed a superior, inferior or equal role in relation to the recipient of the letter and compared whether students assumed the same role in relation to patients and GPs.

Results: 18 pairs of patient and GP letters were analyzed. The analysis showed that students conveyed more drug-related problems to GPs than to patients. Furthermore, students assumed an equal relationship to GPs, whereas they frequently took superior positions when writing to patients. Students reported lifestyle problems both to GPs and to patients.

Conclusion: Pharmacy students in a Danish medication review and reconciliation model managed to detect and address lifestyle problems of patients to their GPs, thereby facilitating the merger of their professional-technical perspective with the life-world perspective of patients. However, patients were not encouraged to become more involved in the disease management process.