Factors affecting physician implementation of hospital pharmacists' medication appropriateness recommendations in older adults

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dc.contributor.authorDalton, Kieranen
dc.contributor.authorFleming, Aoifeen
dc.contributor.authorO'Mahony, Denisen
dc.contributor.authorByrne, Stephenen
dc.date.accessioned2024-12-19T14:54:59Z
dc.date.available2024-12-19T14:54:59Z
dc.date.issued2022en
dc.description.abstractAims: Non-implementation of pharmacist recommendations by physician prescribers may prolong potentially inappropriate prescribing in hospitalised older adults, increasing the risk of adverse clinical outcomes. The aim of this study was to ascertain the key factors affecting physician prescriber implementation of pharmacists' medication appropriateness recommendations in hospitalised older adults. Methods: Semi-structured interviews were conducted with hospital pharmacists and physicians who provided care to older adults (≥65 years) in 2 acute university teaching hospitals in Ireland. Content analysis was employed to identify the key themes that influence physician prescriber implementation of pharmacist recommendations. Results: Fourteen interviews were conducted with 6 hospital pharmacists and 8 hospital physicians between August 2018 and August 2019. Five key factors were found to affect physician implementation of pharmacist recommendations: (i) the clinical relevance and complexity of the recommendation—recommendations of higher priority and those that do not require complex decision-making are implemented more readily; (ii) interprofessional communication—recommendations provided verbally, particularly those communicated face to face with confidence and assertion, are more likely to be implemented than written recommendations; (iii) physician role and identity—the grade, specialty, and personality of the physician significantly affect implementation; (iv) knowing each other and developing trusting relationships—personal acquaintance and the development of interprofessional trust and rapport greatly facilitate recommendation implementation; and (v) the hospital environment—organisational issues such as documentation in the patient notes, having the opportunity to intervene, and the clinical pharmacy model all affect implementation. Conclusion: This study provides a deeper understanding of the underlying behavioural determinants affecting physician prescriber implementation of pharmacist recommendations and will aid in the development of theoretically-informed interventions to improve medication appropriateness in hospitalised older adults. © 2021 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationDalton, K., Fleming, A., O'Mahony, D. and Byrne, S. (2022) 'Factors affecting physician implementation of hospital pharmacists' medication appropriateness recommendations in older adults', British Journal of Clinical Pharmacology, 88(2), pp.628-654. https://doi.org/10.1111/bcp.14987en
dc.identifier.doihttps://doi.org/10.1111/bcp.14987en
dc.identifier.endpage654en
dc.identifier.issued2
dc.identifier.journaltitleBritish Journal of Clinical Pharmacologyen
dc.identifier.startpage628en
dc.identifier.urihttps://hdl.handle.net/10468/16760
dc.identifier.volume88
dc.language.isoenen
dc.publisherJohn Wiley and Sons Incen
dc.rights© 2021, the Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in anymedium, provided the original work is properly cited and is not used for commercial purposes.en
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/en
dc.subjectAgeden
dc.subjectHospitalsen
dc.subjectTeachingen
dc.subjectHumansen
dc.subjectInappropriate prescribingen
dc.subjectPharmacistsen
dc.subjectPharmacy serviceen
dc.subjectPhysiciansen
dc.subjectArticleen
dc.subjectAssertivenessen
dc.subjectClinical pharmacyen
dc.subjectContent analysisen
dc.subjectDecision makingen
dc.subjectDocumentationen
dc.titleFactors affecting physician implementation of hospital pharmacists' medication appropriateness recommendations in older adultsen
dc.typeArticle (peer-reviewed)en
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