Challenges in implementing pharmacist-led admission medication reconciliation in hospital practice: a qualitative...

Area of Science:

• Pharmacy Practice
• Health Services Research
• Qualitative Research

Background:

• Pharmacist-led admission medication reconciliation (MedRec) is vital for safe medication management during care transitions.
• Despite proven benefits, widespread implementation of admission MedRec in hospitals is challenging.
• This study investigated barriers and facilitators to pharmacist-led admission MedRec in a Taiwanese hospital.

Purpose of the Study:

• To explore context-specific barriers and facilitators influencing the implementation of pharmacist-led admission MedRec.
• To identify factors hindering and promoting the integration of MedRec into daily hospital workflows.
• To inform the development of strategies for successful MedRec implementation.

Main Methods:

• A narrative qualitative study employing semi-structured interviews.
• Purposive sampling of 15 pharmacists with admission MedRec experience.
• Analysis using inductive thematic analysis, guided by the PRECEDE-PROCEED model.

Main Results:

• Pharmacists value MedRec but face prioritization challenges due to time constraints.
• Lack of performance feedback and recognition were identified as reinforcing barriers.
• Gaps in professional competencies, training, information systems, and workflow interruptions impeded implementation.

Conclusions:

• Key barriers include time limitations, unclear prioritization, and insufficient feedback mechanisms.
• Pharmacists acknowledge MedRec's value but often deprioritize it in practice.
• The PRECEDE-PROCEED model offers a framework for targeted strategies to enhance MedRec sustainability.