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

Int J Clin Pharm. 2023 Feb;45(1):26-37. doi: 10.1007/s11096-022-01507-3. Epub 2022 Nov 17.

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.

Keywords: Care homes; Medicines reconciliation; Residential homes; Transitionary care.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Anthropology, Cultural
  • Hospitals
  • Humans
  • Nursing Homes*
  • Patient Discharge*