title: Nurses' and pharmacists' learning experiences from participating in interprofessional medication reviews for elderly in primary health care - a qualitative study.
abstract: BACKGROUND
  Traditionally, drug prescription and follow up have been the sole responsibility of physicians. However, interprofessional medication reviews (IMRs) have been developed to prevent drug discrepancies and patient harm especially for elderly patients with polypharmacy and multimorbidity. What participating nurses and pharmacists learn from each other during IMR is poorly studied. The aim of this study was to investigate nurses' and pharmacists' perceived learning experience after participating in IMRs in primary health care for up to two years.
  
  
  METHODS
  A qualitative study with semi-structured focus group interviews and telephone interviews with nurses and pharmacists with experience from IMRs in nursing homes and home based services. The data was analysed thematically by using systematic text condensation.
  
  
  RESULTS
  Thirteen nurses and four pharmacists were interviewed. They described some challenges concerning how to ensure participation of all three professions and how to get thorough information about the patient. As expected, both professions talked of an increased awareness with time of the benefit of working as a team and the perception of contributing to better and more individual care. The nurses' perception of the pharmacist changed from being a controller of drug management routines towards being a source of pharmacotherapy knowledge and a discussant partner of appropriate drug therapy in the elderly. The pharmacists became more aware of the nurses' crucial role of providing clinical information about the patient to enable individual advice. Increasingly the nurses learned to link the patient's symptoms of effect and side effect to the drugs prescribed.
  
  
  CONCLUSIONS
  Although experiencing challenges in conducting IMRs, the nurses and pharmacists had learning experiences they said improved both their own practice and the quality of drug management. There are some challenges concerning how to ensure participation of all three professions and how to get thorough information about the patient.
authors.affiliation: Department of Pharmacy, Faculty of Health Sciences, Nord University, Namsos, Norway. hege.t.bell@nord.no.|Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway. hege.t.bell@nord.no.
authors.forename: H T
authors.initials: HT
authors.lastname: Bell
authors.affiliation: School of Pharmacy, University of Oslo, Oslo, Norway.
authors.forename: A G
authors.initials: AG
authors.lastname: Granas
authors.affiliation: Centre for Care research Mid- Norway, Steinkjer, Norway.|Department of Nursing, Mid University, Østersund, Sweden.
authors.forename: I
authors.initials: I
authors.lastname: Enmarker
authors.affiliation: Department of Pharmacy, Faculty of Health Sciences, Nord University, Namsos, Norway.|Centre for Care research Mid- Norway, Steinkjer, Norway.
authors.forename: R
authors.initials: R
authors.lastname: Omli
authors.affiliation: Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: A
authors.initials: A
authors.lastname: Steinsbekk
mesh_terms: D000368:Aged; D011307:Drug Prescriptions / Q000592:standards*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D024802:Nurse's Role; D010595:Pharmacists / Q000458:organization & administration*; D010820:Physicians / Q000600:supply & distribution*; D019338:Polypharmacy; D011320:Primary Health Care / Q000458:organization & administration*; D018794:Problem-Based Learning; D024382:Professional Role; D036301:Qualitative Research
keywords: Inappropriate drug use; Learning; Medication review; Nurse; Pharmacist; Primary care