title: Barriers and facilitators of medication reconciliation processes for recently discharged patients from community pharmacists' perspectives.
abstract: BACKGROUND
  Community pharmacists play a vital part in reconciling medications for patients transitioning from hospital to community care, yet their roles have not been fully examined in the extant literature.
  
  
  OBJECTIVE
  The objectives of this study were to: 1) examine the barriers and facilitators community pharmacists face when reconciling medications for recently discharged patients; and 2) identify pharmacists' preferred content and modes of information transfer regarding updated medication information for recently discharged patients.
  
  
  METHODS
  Community pharmacists were purposively and conveniently sampled from the Wisconsin (U.S. state) pharmacist-based research network, Pharmacy Practice Enhancement and Action Research Link (PEARL Rx). Community pharmacists were interviewed face-to-face, and transcriptions from audio recordings were analyzed using directed content analysis. The Theory of Planned Behavior (TPB) guided the development of questions for the semi-structured interviews.
  
  
  RESULTS
  Interviewed community pharmacists (N = 10) described the medication reconciliation process to be difficult and time-consuming for recently discharged patients. In the context of the TPB, more barriers than facilitators of reconciling medications were revealed. Themes were categorized as organizational and individual-level themes. Major organizational-level factors affecting the medication reconciliation process included: pharmacy resources, discharge communication, and hospital resources. Major individual-level factors affecting the medication reconciliation process included: pharmacists' perceived responsibility, relationships, patient perception of pharmacist, and patient characteristics. Interviewed pharmacists consistently responded that several pieces of information items would be helpful when reconciling medications for recently discharged patients, including the hospital medication discharge list and stop-orders for discontinued medications.
  
  
  CONCLUSIONS
  The TPB was useful for identifying barriers and facilitators of medication reconciliation for recently discharged patients from community pharmacists' perspectives. The elucidation of these specific facilitators and barriers suggest promising avenues for future research interventions to improve exchange of medication information between the community pharmacy, hospitals, and patients.
authors.affiliation: Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA; University of Wisconsin-Madison, School of Pharmacy, Sonderegger Research Center, Madison, WI, USA. Electronic address: kennelty@wisc.edu.
authors.forename: Korey A
authors.initials: KA
authors.lastname: Kennelty
authors.affiliation: University of Wisconsin-Madison, School of Pharmacy, Sonderegger Research Center, Madison, WI, USA.
authors.forename: Betty
authors.initials: B
authors.lastname: Chewning
authors.affiliation: University of Wisconsin-Madison, School of Pharmacy, Sonderegger Research Center, Madison, WI, USA.
authors.forename: Meg
authors.initials: M
authors.lastname: Wise
authors.affiliation: Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA; University of Wisconsin-Madison, Department of Medicine, Division of Geriatrics, Madison, WI, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Kind
authors.affiliation: Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA; University of Wisconsin-Madison, School of Nursing, USA.
authors.forename: Tonya
authors.initials: T
authors.lastname: Roberts
authors.affiliation: University of Wisconsin-Madison, School of Pharmacy, Sonderegger Research Center, Madison, WI, USA.
authors.forename: David
authors.initials: D
authors.lastname: Kreling
mesh_terms: D001291:Attitude of Health Personnel; D003157:Community Pharmacy Services / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D059065:Medication Reconciliation / Q000379:methods*; D010351:Patient Discharge / Q000639:trends; D010595:Pharmacists / Q000639:trends; D011369:Professional-Patient Relations; D000069341:Transitional Care / Q000639:trends
keywords: Community pharmacy; Medication reconciliation; Qualitative methods; Transitions of care