Contextual factors influencing medicines-related interventions to support safe transitions for care home residents post hospital discharge: a systematic review and meta-ethnographic synthesis

Janani Kandiah, Hamde Nazar, Jeanette Blacklock, Anna Robinson, David Wright

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Residents of care or nursing homes are at a higher risk of medication-related harm, especially during care transitions. No medicines-related intervention has been identified that supports the safe transition for these residents moving into their residence following hospital discharge. A model of care integrating a number of intervention components is suggested to be most effective

Aim: To investigate, via a systematic review and meta-ethnography, the factors which influence the impact of medicines related interventions.

Method: In December 2020, Pubmed, MEDLINE, EMBASE, PsycINFO, and CINAHL Complete were systematically searched. All studies reporting on medicines-related interventions for residents following hospital discharge were included. Quality assessment was undertaken with a validated tool. Meta-ethnography was used to investigate the factors which influenced how interventions did, or did not work. Findings were mapped to a validated conceptual framework for integrated care.

Results: From 3884 studies, nine met the inclusion criteria and were analysed. These were generally of medium quality (n = 6). The interventions were diverse: some tackled the transition process, some tackled follow-up care and some interventions involved both. The meta-ethnography, using the a priori conceptual framework, captured factors reported within the studies that influenced implementation, delivery and/or outcomes.

Conclusion: The review and synthesis informed the development of a conceptual model for transitionary care for this population group. Researchers and decision-makers can use this as a tool to understand their local context and inform future intervention design, implementation and evaluation in this clinical area.
Original languageEnglish
JournalInternational Journal of Clinical Pharmacy
Early online date17 Nov 2022
DOIs
Publication statusE-pub ahead of print - 17 Nov 2022

Keywords

  • Care homes
  • Medicines reconciliation
  • Residential homes
  • Transitionary care

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