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Stratification in pharmaceutical care: a concept analysis
Ramón Morillo-Verdugo1, Fiona McIntyre2, Enrique Contreras Macías3
1Pharmacy, Hospital Universitario de Valme, Sevilla, Spain.
Background:
The term stratification is increasingly used in pharmaceutical care to guide the allocation of interventions and optimise patient follow-up. However, its conceptual boundaries remain ambiguous and are frequently conflated with related constructs such as triage, clinical scoring or prioritisation, thereby compromising consistency in implementation. This lack of conceptual clarity hinders the development of standardised tools and limits the comparability and transferability of stratified care models in clinical pharmacy practice.
Objective:
To clarify the concept of stratification in pharmaceutical care by identifying its defining attributes, antecedents, consequences and empirical referents.
Methods:
A structured concept analysis was conducted using the Walker and Avant framework. A comprehensive literature search was performed across major biomedical databases covering the period from January 2000 to May 2025. Empirical studies, theoretical articles, conceptual frameworks and models addressing stratification or patient prioritisation in pharmaceutical care and related health services were included. Relevant publications were screened independently by both authors and analysed thematically.
Results:
Eleven publications were included in the concept analysis. Four defining attributes of stratification in pharmaceutical care were identified: patient-centred segmentation, prioritisation of care intensity, resource-sensitive allocation and structured re-stratification over time. Key antecedents included increasing clinical complexity, limited pharmacist availability and the need for value-based care. Consequences and empirical referents were also identified, allowing stratification to be distinguished from related constructs such as triage or risk scoring.
Conclusion:
This concept analysis establishes a theory-based conceptual foundation for stratification in pharmaceutical care. Clarifying its meaning may support greater conceptual consistency and inform the development, implementation and evaluation of structured patient prioritisation models across healthcare settings.
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