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Comprehensive medication reviews by ward-based pharmacists in Swedish hospitals: what does the patient have to say?

Kempen, Thomas G.H.; K�lvemark, Amanda; Gillespie, Ulrika; Stewart, Derek


Thomas G.H. Kempen

Amanda K�lvemark

Ulrika Gillespie

Derek Stewart


Rationale, aims, and objectives: Inappropriate medication prescribing and use amongst older patients is a major patient safety and health care problem. To promote appropriate medication prescribing and use, comprehensive medication reviews (CMRs) by ward-based pharmacists, including follow-up telephone calls after hospital discharge, have been conducted in older patients in the context of a randomized controlled trial (RCT). One of the key actors in a CMR is the patient. To support the understanding of the effects of CMRs on patients' health outcomes and improve clinical practice, knowledge about the patient perspective is needed. We therefore aimed to explore older patients' experiences with, and views on, hospital-initiated CMRs and follow-up telephone calls by ward-based clinical pharmacists within an RCT. Methods: We conducted in-depth semi-structured interviews with 15 patients (66-94 years) and carers from four hospitals in Sweden. Discussion topics included communication, information, decision-making, and effects on the patient. Interviews took place after discharge, were audio-recorded, transcribed verbatim, and thematically analysed using a framework approach. Results: In general, patients' experiences and views were positive. Seven key themes were identified: (a) feeling of being taken care of and heterogenous health effects; (b) the pharmacist is competent; (c) despite the unclear role of pharmacists, their involvement is appreciated; (d) patients rely on health care professionals for decision-making; (e) importance of being informed, but receiving and retaining information is problematic; (f) time, location, and other factors influencing the effectiveness of CMRs; and (g) generic substitution is a problem. Conclusions: Older patients generally have positive experiences with and views on CMRs and follow-up telephone calls. However, some factors, like the unclear role of the ward-based pharmacist and problems with receiving and retaining information, may negatively impact the effectiveness of these interventions. Future initiatives on hospital-initiated CMRs by clinical pharmacists should address these negative factors and utilize the positive views.


KEMPEN, T.G.H., KÄLVEMARK, A., GILLESPIE, U. and STEWART, D. 2020. Comprehensive medication reviews by ward-based pharmacists in Swedish hospitals: what does the patient have to say? Journal of evaluation in clinical practice [online], 26(1), pages 149-157. Available from:

Journal Article Type Article
Acceptance Date Feb 9, 2019
Online Publication Date Mar 4, 2019
Publication Date Feb 29, 2020
Deposit Date Jul 12, 2019
Publicly Available Date Mar 5, 2020
Journal Journal of Evaluation in Clinical Practice
Print ISSN 1356-1294
Electronic ISSN 1365-2753
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 26
Issue 1
Pages 149-157
Keywords Clinical pharmacists; Health services for the aged; Interdisciplinary health team; Patient involvement; Qualitative research; Review; Drug utilization
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