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Qualitative investigation of barriers to providing an electronic hospital to community pharmacy referral service for discharged patients

Lookup NU author(s): Dr Hamde Nazar



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2023 Khayyat, Nazar. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.There has been a sustained interest in transfer of care (ToC) services, from hospital to home, in the past twenty years. In England, an electronic referral (e-referral) service from hospital to community pharmacy has been provided since 2014. However, to date, there has been little information about service implementation and delivery. This study investigates the barriers to this referral process in hospital and community pharmacy settings, and barriers to providing subsequent community pharmacy interventions from the perspectives of the service leaders (SLs), hospital pharmacy staff (HPS) and community pharmacists (CPs). Semi-structured face-to-face or telephone interviews were conducted with the key informants from two tertiary hospitals and nine pharmacies. The Consolidated Framework for Implementation Research (CFIR) tool informed the data collection tools and data analysis. A total of three SLs, ten HPS and nine CPs were interviewed. Data analysis identified various barriers to the provision of the e-referral service. Some were related to (1) patient engagement, e.g., patients' awareness/acceptance of the service, (2) the SLs and other National Health Service hospitals, e.g., lack of monitoring of the service progress, (3) the HPS, e.g., resource limitations, or (4) the CPs, e.g., lack of understanding/appreciation of the service. In-depth understanding of barriers related to the provision of e-referral service are essential to drive improvement and facilitate wider diffusion and adoption. The use of implementation science and behaviour change model as a lens to assess this service enables the identification of certain behaviours that can be modified to produce the required change to drive better implementation and delivery.

Publication metadata

Author(s): Khayyat SM, Nazar H

Publication type: Article

Publication status: Published

Journal: PLoS One

Year: 2023

Volume: 18

Issue: 3

Online publication date: 31/03/2023

Acceptance date: 18/03/2023

Date deposited: 17/04/2023

ISSN (electronic): 1932-6203

Publisher: Public Library of Science


DOI: 10.1371/journal.pone.0283836

PubMed id: 37000829


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