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Lookup NU author(s): Dr Charlotte RichardsonORCiD, Dr Matthew CooperORCiD, Olivia Atkinson, Dr Laura LindseyORCiD, Professor Hamde NazarORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© Author(s) (or their employer(s)) 2025. Objective: The aim of this work was to understand carer involvement in transitions of care from hospital to home in relation to medicines management. Specifically, via a realist review, to describe how carers provide support, to what extent do they support patients and under what circumstances are carers able to provide support towards patient care in relation to medicines management. Design: A realist review was conducted in line with a published protocol and as registered via PROSPERO (CRD42021262827). An initial programme theory (PT) was developed before searches of three databases, PubMed, CINHAL and EMBASE, were conducted in accordance with eligibility criteria. Data were extracted from eligible studies and synthesised into realist causal explanations in the form of Context-Mechanism-Outcome-Configurations (CMOCs) and the PT was refined. Throughout the review, a patient and PPIE group (n≥5) was involved, meeting five times, to inform the research focus and develop CMOCs and the PT by providing feedback and ensuring they capture the carer experience. Results: Following title and abstract screening of 4835 papers, the final number of included articles was 208. The evidence synthesis identified 31 CMOCs which were categorised into three themes: (1) continuum of support; (2) understanding the carers' priorities, role and responsibilities through shared decision-making (SDM) and (3) access to appropriate materials, resources and support information. These themes were formed into an updated PT with accompanying narrative that explained the transition from hospital to home involving carers in medicines management and identified possible areas for future intervention development. Conclusion: This review provides insights and recommendations on how carers can be better supported when managing medicines when patients are discharged from hospital. Carers need a continuum of support throughout and following the transition. Healthcare professionals can support this by understanding the carer's priorities, role and responsibilities through SDM during the hospital stay. Consequently, carers can then be offered access to appropriate materials, resources and support information which allows them to provide better care relating to medicines in the long term.
Author(s): Richardson CL, Cooper M, Atkinson O, Black D, Lindsey L, Cooper C, Nazar H, Wong G, Hughes C
Publication type: Review
Publication status: Published
Journal: BMJ Open
Year: 2025
Volume: 15
Issue: 11
Online publication date: 13/11/2025
Acceptance date: 21/10/2025
ISSN (print): 2044-6055
ISSN (electronic): 2044-6055
Publisher: BMJ Publishing Group
URL: https://doi.org/10.1136/bmjopen-2025-107826
DOI: 10.1136/bmjopen-2025-107826
PubMed id: 41248395
Data Access Statement: Data are available upon reasonable request. The literature contributing to the development of the CMOCs is summarised within Supplementary material 3. Further detailed data can be requested from the corresponding author.
