Interprofessional medication review in the outpatient setting: A mixed-method contextual analysis

Medication review (MR) reduces drug-related problems and improves medication safety. Community pharmacists are trained to deliver MRs, but implementation in outpatient settings remains low.

This contextual analysis aimed to develop an Implementation Research Logic Model with strategies for the implementation of an interprofessional MR service in the outpatient setting. Feasibility and acceptability of the service for primary care patients were pilot tested.

A mixed-methods study design combining qualitative and quantitative data was used. The Basel Approach for coNtextual ANAlysis framework guided the contextual analysis, which included a scoping review, pilot study, qualitative interviews, and stakeholder involvement. For the pilot study, a convenience sample of co-working general practitioner (GP) practices and community pharmacies was recruited and instructed to deliver the new MR service. Screening questionnaires and process indicators were analyzed descriptively. Semistructured interviews were performed with GPs, medical practice assistants, community pharmacists, and patients and analyzed for feasibility and acceptability of the service.

One hundred seventy-two patients from 3 GP practices completed the screening for increased risk of drug-related problems, and 23 were referred to the community pharmacy. MRs took 94 ± 61 minutes and led to 2.95 ± 1.54 suggestions to optimize medication therapy. The interviewed health care professionals were satisfied with the instruction workshop and valued the idea of the service; however, the process was criticized for several reasons: lack of time, more work in primary health care, and difficulties in involving the whole team.

This contextual analysis of an interprofessional MR service to improve patients' medication safety was highly accepted by health care professionals and patients. Integration into daily routine should be further improved to increase feasibility. These results will be used to widely and sustainably implement interprofessional MR in Swiss primary care.