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Pharmacist, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
Associate Professor, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto
Pharmacist, Toronto General Hospital, University Health Network
Cinical Site Leader, Toronto General Hospital, University Health Network; Assistant Professor, Leslie Dan Faculty of Pharmacy, University of Toronto
Reprints: Dr. Fernandes, Inpatient Pharmacy Department, University Health Network—Toronto General Hospital, 200 Elizabeth St., Gerrard Wing, Ground Floor, Rm. 579, Toronto, Ontario M5G 2C4, Canada, fax 416/340-3685, olavo.fernandes{at}uhn.on.ca
BACKGROUND: Continuity of care is required as patients move from the care of one pharmacist to another. The appropriate transfer of medication information between pharmacists as well as to patients at these times is essential in order to prevent drug-related problems (DRPs).
OBJECTIVE: To develop a tool to transfer medication information between various pharmacists caring for the same patients. Secondary objectives were to evaluate the tool based on utility in practice and satisfaction of pharmacists.
METHODS: The project consisted of a needs assessment involving in-depth interviews with patients and pharmacists and a literature review. These data were used to develop an optimal tool for medication information transfer between pharmacists in different practice settings. The tool was evaluated in a feasibility pilot for potential utility and pharmacist satisfaction.
RESULTS: The tool created called EMITT (electronic medication information transfer tool) facilitates the communication of information to outpatient pharmacists including a letter and an up-to-date list of the patient's drugs. A total of 187 medication issues were communicated within 40 transferred letters, 61 of which required active follow-up, which potentially prevented 348 DRPs if the receiver of the information acted on the information that was provided. The 3 most common issues that required follow-up were restarting a held medication (n = 13), adjustment of doses based on laboratory results (n = 11), and starting a new indicated medication in the future (n = 7).
CONCLUSIONS: A tool can be created to help address the gap in communication between pharmacists when patients move between interfaces of care by evaluating the needs of healthcare professionals involved in the information transfer process. It is envisioned that the elements of our tool can be easily adapted to other institutions to improve medication information transfer.
Key Words: drug-related problems, medication information transfer.
Published Online, May 30, 2006. www.theannals.com, DOI 10.1345/aph.1G707
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