Information needs and patient perceptions of the quality of medication information available in hospitals: a mixed method study.

Background Providing appropriate medication information to patients is of utmost importance for optimal pharmacotherapy. (Un)intentional miscommunication and information gaps resulting in unmet needs could negatively affect patient's ability to use their medication properly. Objective To identify the information needs and patient perceptions of the quality of medication information available in hospitals in the Netherlands. Setting Cardiology, oncology, or rheumatology department of five hospitals. Methods Adult cardiology, oncology, and rheumatology patients participated in this mixed-method study. Focus groups and individual interviews were held to identify patients' views on the medication information and their information needs. Outcomes were used to construct a questionnaire that was used in a survey among patients to compare existing medication information with patients' needs, and to judge the quality of the provided information. Main outcome measure Patients needs with medication information. Results Four themes derived from interviews with 44 patients: (1) Content; almost all patients acknowledged to receive insufficient information not meeting their personal needs. (2) Moment of delivery; patients were dissatisfied with the timing. (3) Method of delivery; patients highly preferred verbal and written information. (4) Contextual quality prerequisites that should be met according to patients; medication information should be accessible, comprehensive, reliable and understandable. A total of 352 patients completed the questionnaire. Almost all patients reported all items as important, whereas up to 74.6% patients were not informed. Up to half of the patients perceived verbal information from healthcare providers, written information of leaflets and folders of insufficient quality. Conclusion Patients attending Dutch hospitals have needs for extensive medication information, which should be tailored to their individual needs. According to patients the quality of medication information available in hospitals can be improved.

Creating an Interprofessional guideline to support patients receiving oral anticoagulation therapy: a Delphi exercise.

Background Oral anticoagulation therapy has proven beneficial impact on the prevention of thromboembolic events. However, the use of antocoagulatns also increases the risk of bleeds. To maximize the benefits and minimize the risks of the treatment, guidance on appropriate use of oral anticoagulants is essential. An international guideline describing relevant components and requirements for pharmaceutical care for patients receiving a therapy woth oral antocoagulants would increase the quality of care. However, recommendations on pharmaceutical care for patients on anticoagulation is lacking. Objective This study aims to develop an interprofessional guideline to support patients in their use of oral anticoagulation therapy. Method Two systematic literature searches were performed on existing guidelines on the management and interventions to improve-oral anticoagulant use, to generate possible recommendations. Subsequently, an international expert panel with 26 pharmacists with extensive experience in clinical and/or scientific work on anticoagulation from a total of 22 European and 4 non-European countries was constituted. With this (geographically well distributed) expert panel, a four-round internet-based Delphi technique was conducted to reach consensus on their relevance. Items were ranked on a 1-10 scale of agreement. A median agreement score of ≥ 7.5 was considered the threshold for consensus. Levels of importance were rated on a 1-3 scale. Setting A global network of 26 pharmacists specialized in oral antocoagulation therapy. Main outcome measure Development of inter-professional guideline. Results After the four Delphi rounds 18 guideline recommendations were formulated. Consensus of opinion was achieved for all recommendations (median agreement: 8.5-10.0), whereas mean levels of importance were between 1.1 and 2.0 (SD: 0.2-0.7). The following domains were rated as most important targets for improving the care around oral anticoagulation: 'INR-monitoring', 'Transfer of care between health care settings', 'Adherence to medication', 'Patient communication and engagement', and 'Medication reconciliation and medication review'. Conclusion The 18 recommendations included in this guideline provide the base for optimization of anticoagulation care across different countries/healthcare systems. Future work involves translating the guideline recommendations into clinical practice. Once implemented, the recommendations of the guideline will support health care providers with the pharmaceutical care for patients on, oral anticoagulation which will improve the effective and safe use of these medicines.