Introduction of medication review and medication report in Swedish hospital and primary care, using a theory-based imple
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(2020) 20:867
RESEARCH ARTICLE
Open Access
Introduction of medication review and medication report in Swedish hospital and primary care, using a theory-based implementation strategy Siw Carlfjord1* , Eva Malmberg2 and Carina Skoglund3
Abstract Background: The development of routines regarding medication is important to avoid medication-related harm. Medication review and medication reports have earlier been found to be effective, but their implementation is not always successful. The aim of this study was to evaluate the introduction of medication review/medication report in hospital and primary care, in terms of perceptions of the implementation strategy, adoption and sustainability, in one Swedish county. Methods: The study included 105 clinics. Data was collected from interviews with managers immediately after implementation, survey data and registry data collected five years later. Quantitative data was analysed using nonparametric statistical tests. Open-ended questions were analysed with qualitative methods. Results: The implementation activities were found satisfying, and managers were satisfied with their own influence over the process. After five years medication review and medication reports were reported mainly implemented by the managers. Facilitating factors reported were routines, staff influence, dedication, reminders, and a stable workforce, while hindering factors reported were organizational factors, less commitment and flaws in reporting. Registry data showed that performance of medication review was very limited in primary care. In hospital care medication review was registered in about one fifth of the patients, while medication reports, only relevant for hospital care, was registered in half of the patients. Conclusions: The managers’ perceptions of the implementation process were mainly positive, and they found the new practices of medication review/medication report implemented. Implementation success, however, was not supported by registry data, showing the need for reliable outcome measures for implementation. Keywords: Quality improvement, Medication report, Medication review, Implementation
* Correspondence: [email protected] 1 Department of Health, Medicine and Caring Sciences, Division of Community and Heath, Linköping University, SE-58183 Linköping, Sweden Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitte
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