Engaging Community Pharmacies in Promoting Outpatient Medication Safety - Identifying and Prioritizing Research Needs by Modified Nominal Group Technique

Abstract

Introduction: Medication errors are one of the most endangering factors for patient safety, and they have become a key target for improvement in health- and social care systems worldwide. The most current development needs are related to outpatient care; however, up-to-date medication safety research and improvement activities have primarily focused on hospital environments. To promote medication safety in outpatient care, community pharmacies could be more effectively utilized.

Objective: To identify the most central research needs, which would promote the use of community pharmacies in outpatient medication risk management and enhance collaboration between community pharmacies and other parts of the health- and social care system.

Methods: The study applied a modified nominal group technique. A group of Finnish patient and medication safety experts (n=28) participated in the study and were divided into four nominal groups (incl. a pilot group). Data collection was conducted through electronic surveys and facilitated online group meetings. The collected data were analyzed using qualitative inductive thematic analysis and quantitative descriptive analysis by the van Breda technique.

Results: The final data comprised 83 research needs organized under five main themes with 22 subthemes. The most prioritized research needs covered all five main themes, which were: medication safety collaboration (final rank proportion 30%); medication care pathways (27%); operating processes of community pharmacies (17%); medication safety incident reporting (16%); and community pharmacy-based services improving medication safety (11%).

Conclusion: The identified research needs for promoting outpatient medication safety by involving community pharmacies in medication risk management, covered a wide range of areas. Producing evidence about the effectiveness and cost-effectiveness of activities in these areas is particularly needed for practice development and policymaking, together with updating regulations supporting the implementation of the produced evidence.

Keywords: collaboration; community pharmacy service; medication care pathway; medication risk management; medication safety incident.

Figure 1

The comparison of the steps of the traditional nominal group technique (NGT) and the modified NGT used in this study.

Figure 2

Outline of the modified nominal group technique (NGT) study.