Abstract:

Effective transition of care (TOC) is critical in enhancing patient outcomes, reducing hospital readmissions, reducing adverse events, cost of treatment and strengthening healthcare systems. This study investigates the knowledge, attitudes, and practices of pharmacists regarding TOC services in tertiary hospitals in Lagos, Nigeria. This study aims to evaluate hospital pharmacists' understanding, implementation, barriers and comparative practices of Transition of care services within the hospital setting. A cross-sectional quantitative study was conducted, utilizing non-probability sampling to select participants. A structured questionnaire, pre-tested with pharmacists from a private health facility, was distributed via Google Forms to gather data. Descriptive and inferential statistics were performed using SPSS Version 23.0. 64.5% of the surveyed pharmacists participated in the study. Notably, 87.3% had not received formal training in TOC, yet 85.3% understood the component of the process. Furthermore, 76.2% believed that TOC services significantly improve patient outcomes. Regarding practice, 24.6% of pharmacists were unaware of medication reconciliation as part of TOC services. Regarding the comparison of performance across the five tertiary institutions, the study revealed significant differences in knowledge p=0.034, however no significant differences were found in attitude and perceived barriers to transition of care services p=0.057 and 0.340 respectively. The findings highlight gaps and strengths in the knowledge, attitude and practice regarding transition of care services across the five tertiary hospitals. while pharmacists possess a moderate level of knowledge and a positive attitude towards TOC services, their practical application of medication reconciliation remains limited.

References:

[1].   Al-Hashar, A., Al-Zakwani, I., Eriksson, T., Sarakbi, A., Al Za'abi, M., 2018, Impact of medication reconciliation and review and counseling, on adverse drug events and healthcare resource use. International Journal of Clinical Pharmacy, 40(5), 1154-1164.

[2].   Nosé, M., Recla, E., Trifirò, G., & Barbui, C., 2021, Risk of severe mental disorders among    users of typical and atypical antipsychotics: A retrospective cohort study. Schizophrenia Research, 162(1-3), 181-186.

[3].   Jokanovic, N., Tan, E. C. K., van den Bosch, D., Kirkpatric, C. M., Dooley, M. J., Bell, J. S., 2018, Clinical medication review in Australia: A systematic review. Res Soc Adm Pharm. 12(3):384–418.

[4].   Abbas, K. M., Abdulridha, M. K., 2022, Knowledge, Attitude and Practice of Pharmacist about Inpatient Medication Therapy Management Services; National Cross-Sectional Study. International Journal of Drug Delivery Technology. 12(3):1298-1304.

[5].   Coleman and Berenson, 2024, Lost in Transition. Ann Intern Med;140:533-536

[6].   Rita, A., Ogheneovo, A., David, A., Brian, O., Azuka, O., Angel, N., 2020. Knowledge, Attitude and Practice of Medication Therapy Management among Hospital Pharmacists in Delta State, Nigeria. Acta Sci Pharm Sci.;4(8):118–26.

[7].   Obono, M. O., Onedo, T. A., Amorha, C. N., Soyemi, O. I., et.al 2024, Assessment of Pharmacists-patient medication counseling services at the National Orthopaedic Hospital Lagos, Nigeria. West African journal of pharmacy 35(1) 141-147.

[8].   Eniojukan, J. F., & Onedo, T. A., 2015, Evaluation of the knowledge and practice of Pharmaceutical Care among Hospital Pharmacists in Secondary and Tertiary Hospitals in Lagos State, Nigeria. World Journal of Pharmaceutical Sciences 3(7), 1298-1306

[9].   Eniojukan, J. F., Onedo, T., 2015, Patient Medical Records: Evaluation of Knowledge, Perception and Utilization among Hospital Pharmacists in Secondary and Tertiary Hospitals in Lagos State. Pharmaceutical and Biosciences Journal, 01-08.

[10].  Naylor, M. D., Aiken, L. H., Kurtzman, E. T., Olds, D. M., & Hirschman, K. B., 2022, The importance of transitional care in achieving Health Reform. Health Affairs 30(4):746-754.

[11].  Odukoya, O., Chui, M. A., 2021, Relationship between E-prescriptions and p safety: A pharmacist's perspective. Research in Social and Administrative Pharmacy, 11(6), 908-920.

[12].  Bethishou, L., Herzik, K., Fang, N., Abdo, C., & Tomaszewski, D. M., 2020, The impact of the pharmacist on continuity of care during transitions of care: a systematic review. Journal of the American Pharmacists Association, 60(1), 163-177.

[13].  March, K. L, Peters, M. J., Finch, C. K., et al., 2022, Pharmacist Transition-of-Care Services Improve Patient Satisfaction and Decrease Hospital Readmissions. Journal of Pharmacy Practice, 35(1):86-93, doi:10.1177/089719002095826

[14].  Rahayu, S. A., Widianto, S., Defi, I. R., Abdulah, R., 2021, Role of Pharmacists in the Interprofessional Care Team for Patients with Chronic Diseases. Journal of Multidisciplinary Healthcare, 14, 1701–1710. https://doi.org/10.2147/JMDH.S309938

[15].  American case management Association, 2021, Transitions of care Standards, A new way forward. Online www.acmaweb.org

[16].  Adeyemo, A., 2019, Knowledge and attitudes of pharmacists towards transition of care services at LUTH. Nigerian Journal of Pharmacy, 10(3), 112-120.

[17].  Ogunleye, O., 2019, Experiences of pharmacists in transition of care services at LUTH. Journal of Clinical Pharmacy, 5(1), 45-52.

[18].  Lagos Bureau of Statistics. Abstract of Local Government Statistics. From https://mepb.lagosstate.gov.ng/wp-content/uploads/sites/29/2018/06/Abstract-ofLG-Statistics-2017editted.pdf 2017

[19].  Naing, L., Winn, T., and Rusli, B. N., 2006, Practical Issues in Calculating the Sample Size for Prevalence Studies. Medical Statistics. Archives of Orofacial 1, 9-14. https://www.scirp.org/

[20].  Hassell, K., Seston, L., Eden, M., 2005, Pharmacy Workforce Census: Main Findings. 2006,  http://www.rpsgb.org.uk/pdfs/census05.pdf

[21].  Mott, D. A., Doucette, W. R., Gaither, C. A., Kreling, D. H., Pedersen, C. A., Schommer, J. C., 2004, National Pharmacist Workforce Survey: . Pharmacy Manpower Project. 2006, Health workforce Information Centre, Grand Forks, ND

[22].  Health Care Intelligence Pty Ltd, Australia: Study of Demand and Supply of Pharmacists, 2000–2010. 2003, [http://www.guild.org.au/uploadedfiles/Research_and_Development_Grants_Program/Projects/2001-501_fr.pdf]

[23].  Taylor, K. M. G.,, Bates, I. P., Harding, G., 2004, The implications of increasing student numbers for pharmacy education. Pharmacy Education., 4 (1): 33-39.

[24].  Cohen, J. L., Kabat, H. F., Knapp, D. A., Koda-Kimble M. A., Rutledge, C. O., 2000, Pharmaceutical education and the pharmacy workforce. Should we expand our programs? Report of the AACP Argus Commission 1999–2000. American Journal of Pharmaceutical Education. , 64:

[25].  KPMG Consulting for the Department of Health, Social Services and Public Safety: Comprehensive Review of the Pharmacy Workforce. 2001, [http://www.dhsspsni.gov.uk/wfp_comprehensive_review_of_the_pharmacy_workforce.pdf]

[26].  Pedersen, C. A., Doucette, W. R., Gaither, C. A, Mott, D. A., Schommer, J. C.,2000, National Pharmacist Workforce Survey: . Pharmacy Manpower Project. , [http://www.aacp.org/resources/research/pharmacymanpower/Pages/default.aspx]

[27].  Pharmacy Council of New Zealand: Pharmacy Council of New Zealand Workforce Demographics as at 30. 2007, [http://www.pharmacycouncil.org.nz/news/documents/WebsiteReportJuly07_000.pdf

[28].  Peter Bacon and Associates 1999, Assessing Supply in Relation to Prospective Demand for Pharmacists in Ireland. Report to the Higher Education Authority, Dublin.

[29].  Maria, M. T., Lori, H. D., et.al., 2024, Incorporation of Innovative Strategies for Patient Education in Pharmacist-Led Transition of Care Initiatives annals of pharmacotherapy Volume 58, (6) https://doi.org/10.1177/10600280231204118

[30].  Arti, P., Rachael, P., Brooke, W., et.al., 2015, Impact of pharmacist involvement in the transitional care of high-risk patients through medication reconciliation, medication education, and postdischarge call-backs (IPITCH Study) journal of hospital medicine 11(1) 39-44 https://shmpublications.onlinelibrary.wiley.com/authored-by/Prusi/Rachael

[31].  Eric, A., Coleman, M. D., Carla, P., et al., 2006, The TrNsition Care Intervention results of a randomized controlled Trial. Arch Intern Med. 2006;166(17):1822-1828. doi:10.1001/archinte.166.17.1822 https://jamanetwork.com/searchresults?author=Eric+A.+Coleman&q=Eric+A.+Coleman

[32].  Naylor, M. D., Kurtzman E. T., Grabowski, D. C., 2012, Unintended Consequences Of Steps To Cut Readmissions And Reform Payment May Threaten Care Of Vulnerable Older Adults Health Affairs 31(2) https://www.healthaffairs.org/author/Kurtzman%2C+Ellen+T.

[33].  Lauren Balling, Brian, L., Erstad, Kurt Weibel, 2015, Impact of a transition-of-care pharmacist during hospital discharge Journal of the American Pharmacists Association 55 (4), 443-448, 2015 https://doi.org/10.1331/JAPhA.2015.14087

[34].  Bethishou, L., Herzik, K., Fang, N., et.al., 2020, The impact of the pharmacist on continuity of care during transitions of care: a systematic review Journal of the American Pharmacists Association 60 (1), 163-177.

[35].  Al-Tameemi N. K., Sherriff A., 2019, Knowledge, attitude and practice of pharmacists on medication therapy management: a survey in Hospital Pulau Pinang, Penang, Malaysia. J Pharm Heal Care Sci. 5(1):1–9.

[36].  Lech, L. V. J., Husted, G. R., Almarsdottír, A. B., Andersen, T. R. H., Rossing, C., Nørgaard, L. S., 2020, Hospital and Community Pharmacists' Views of and Perspectives on the Establishment of an Intraprofessional Collaboration in the Transition of Care for Newly Discharged Patients. Innov Pharm.11(3):10.24926/iip.v11i3.2440. doi: 10.24926/iip.v11i3.2440. PMID: 34007619; PMCID: PMC8075132.

[37].  Layman, S. N., Whitney, V., Elliott, Sloan, M., Regen, Leigh Anne Keough, 2020, Implementation of a pharmacist-led transitional care clinic, American Journal of Health-System Pharmacy, Volume 77, Issue 12, 15 June 2020, Pages 966–971, https://doi.org/10.1093/ajhp/zxaa080

[38].  Lech, L. V. J., Rossing, C., Andersen, T. R. H., Nørgaard, L. S., & Almarsdóttir, A. B., 2022, Developing a pharmacist-led intervention to provide transitional pharmaceutical care for hospital discharged patients: A collaboration between hospital and community pharmacists. Exploratory Research in Clinical and Social Pharmacy, 7, 100177.

[39].  Chua, S. S., Kok, L. C., Yusof, F. A., et al., 2012, Pharmaceutical care issues identified by pharmacists in patients with diabetes, hypertension, or hyperlipidemia in primary care settings. BMC Health Serv Res.12(1):1–10

[40].  Wooster, J., Bethishou, L., Gernant, S. A., et.al, 2021, Methods and Barriers to communication between pharmacists during Transition of care Journal of pharmacy practice  Volume 36, Issue 3 https://doi.org/10.1177/08971900211064154