Strategies that facilitate medication continuity upon hospital admission

Abstract

Transition of care is the movement of patients between different healthcare locations, providers, or levels of care as their conditions and care requirements evolve. Along the healthcare continuum, transitions of care, such as admission into hospital, represent vulnerable points on the healthcare continuum due to the lack of communication and/or coordination between the different healthcare locations, and/or providers. The major contributor to harm associated with transitions of care is a lack of medication continuity, due to its prevailing use in patient treatment. The most commonly, and well-established intervention to support medication continuity upon hospital admission is conducting medication reconciliation. The investigations that form the chapters of this thesis are sequenced to in the following order: the impact of medication reconciliation (Part B), the use of pharmacy students (Part C), and digital strategies (Part D). Part D was inspired by the COVID-19 pandemic, in which the remote delivery of healthcare was essential. The thesis is divided into five parts involving five studies in total.

Overall, this doctoral thesis has generated novel insights into strategies that facilitate medication continuity upon hospital admission, particularly in the Australian context. The series of studies described in this thesis demonstrate that there are non-digital and digital strategies that can be utilised to obtaining a BPMH for patients upon hospital admission. These strategies are resource efficient, in terms of staffing, time and cost. The WHO affirms that there is no initiative that has been found to be effective in isolation – a range of evidence-based interventions are most likely to be the most effective approach. In an endeavour to address the WHO global health priority: Medication Without Harm, this thesis has presented a range of interventions that can be implemented with minimal constraints on the current system.