Surgical patients’ experiences of information about medication: A qualitative comparative study with a patient-centered medication counseling upon discharge

Abstract

Background: Medical treatment is often prescribed to patients for acute or chronic conditions during hospital admission. Upon discharge, patients must be prepared to manage their medication at home to promote recovery and avoid readmission.

Objective: To investigate the patient experience of information about medication in relation to admission in a general surgical ward when a patient-centered medication counseling upon discharge was compared with usual care.

Methods: A comparative study with qualitative interviews (n=10) was performed using a phenomenological-hermeneutic approach. The intervention was performed by 2 pharmaconomists and comprised patient information, medication reconciliation, physician discussion, patient counselling, written information to primary care physician and telephone follow-up after discharge.

Results: The study revealed 3 themes: firstly, “who keeps the main thread?” was about patients’ experiences of lack of information and a concern of whether the health professionals collaborated and informed each other about observations and treatment plans;  secondly, “being put out of act” reflected patients’ experiences of losing control of the situation due to their illness, health professionals and guidelines; thirdly, “to take the lead” was related to how patients acted to avoid medication errors and continue an ongoing treatment.

Conclusion: A patient-centered medication counseling delivered by pharmaconomists upon discharge did not improve patient experiences of information about medication. The patients experienced a series of encounters with unfamiliar health professionals which resulted in patients not requesting the needed information about medication and treatment plans.