Factors Influencing Patient Willingness to Participate in an Outpatient Pharmacy Transition of Care Program

Purpose: The purpose of this study is to identify any inpatient hospital controllable factors that influence a patient's willingness to participate in an outpatient transition of care program. Methods: A qualitative debrief analysis was conducted to identify strengths and weaknesses of recruitment efforts after the conclusion of a study into a transition of care program. All recruitment personnel involved this study conducted at Medical City Fort Worth were asked to complete a survey battery. It consisted of ten questions designed to elucidate a full picture of the challenges and successes the recruiters encountered during patient interaction experiences. Researchers then read the responses three times. During the first reading the researchers took no notes. On the second reading researchers marked instances of prevailing ideas. On the third reading researchers transferred the most prevalent ideas to separate notes. Researchers then compared all noted ideas identified by the group. From those ideas, three themes pertinent to the profession of pharmacy emerged. Results: The first theme was timeliness. Recruiters unanimously reported requiring multiple visits to obtain patient consent for study participation. Multiple recruiters reported that newly admitted patients were more likely to be overwhelmed by their circumstances while patients who had been scheduled for discharge were willing to discuss medication related programs and services. The second theme was concern about changing pharmacies. More than eighty percent of recruiters reported encountering patient objections related to changing their existing pharmacy provider. One prevailing idea included in this theme is that the community pharmacist is seen as a trusted health-care provider. Recruiters reported that once patients understood that a program pharmacist was going to take personal responsibility for managing their medications that they became more willing to participate. The third theme was ensuring caregiver or family involvement in the decision-making process. Recruiters unanimously reported the need for the patient's social support network to be included in the discussion and decision regarding outpatient health-care. Conclusions: When designing voluntary outpatient medication management programs three themes should be considered to ensure patient involvement: 1. Reduce redundant and non-productive patient encounters by discussing programs closer to discharge or as part of the discharge medication counseling, 2. Be prepared to address concerns over changing, and pharmacies by describing the personal role the pharmacist will be playing in the patient's care. 3. Lastly, ensure that the patient's primary caregiver or social support person in present to discuss changes to outpatient medical care.