Emergency department physicians’ experiences and perceptions with medication-related work tasks and the potential role of clinical pharmacists

ABSTRACT

Purpose

Medication-related problems are frequent among emergency department patients. Clinical pharmacists play an important role in identifying, solving, and preventing these problems, but are not present in emergency departments worldwide. We aimed to explore how Norwegian physicians experience medication-related work tasks in emergency departments without pharmacists present, and how they perceive future introduction of a clinical pharmacist in the interprofessional team.

Methods

We interviewed 27 physicians in three emergency departments in Norway. Interviews were audio-recorded, transcribed, and analysed using qualitative content analysis.

Results

Our informants’ experience with medication-related work tasks mainly concerned medication reconciliation, and few other tasks were systematically performed to ensure medication safety. The informants were welcoming of clinical pharmacists and expressed a need and wish for assistance with compiling patient’s medication lists. Simultaneously they expressed concerns regarding e.g., responsibility sharing, priorities in the emergency department and logistics. These concerns need to be addressed before implementing the clinical pharmacist in the interprofessional team in the emergency department.

Conclusions

Physicians in Norwegian emergency departments welcome assistance from clinical pharmacists, but the identified professional, structural, and legislative barriers for this collaboration need to be addressed before implementation.

KEYWORDS:

• Emergency department
• physicians
• medication safety
• experiences
• pharmacists
• qualitative study
• interviews
• interprofessional team

Acknowledgments

The authors would like to thank Ingvil Nagelhus and Elaine Fjellstad for their contribution in data collection. We would also like to thank study participants, ED staff and collaborating partners for facilitating our study in all three EDs.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The informants in this study did not give written consent for their data to be shared publicly, so due to the sensitive nature of the research supporting data is not available.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17482631.2023.2226941

Additional information

Funding

This work was supported by the Northern Norway Regional Health Authority under grant number HNF1483-19.

Notes on contributors

Tine Johnsgård

Tine Johnsgård is a clinical pharmacist (MPharm) working on her PhD at the Hospital Pharmacy of North Norway Trust and at UiT the Arctic University of Norway, Tromsø. Her research centers around physicians’ experiences with pharmacists in the ED.

Renate Elenjord

Renate Elenjord is a pharmacist (MPharm) and researcher (PhD) working as head of research at the Hospital Pharmacy of North Norway Trust and as an associate professor at UiT the Arctic University of Norway, Tromsø. She is the project manager for the PharmED-study.

Elin C. Lehnbom

Elin C. Lehnbom is a pharmacist (BscPharm/MPharmSc/MclinPharm) and researcher (PhD) working as an associate professor at UiT the Arctic University of Norway, Tromsø and the Linnaeus University in Kalmar, Sweden. Her research focuses on using digital solutions to improve medication management and ultimately patient outcomes. She is experienced within qualitative research.

Torsten Risør

Torsten Risør is a physician (MD) and researcher (PhD) working as an associate professor at the University of Copenhagen and at UiT the Arctic University of Norway, Tromsø. His research involves studies of health professional students and curricula, of emerging patterns of decision-making and interaction in clinical practice, and of local creativity and innovation that creates context-sensitive solutions in local communities. He is experienced in qualitative research, medical anthropology, and family medicine research.

Birgitte Zahl-Holmstad

Birgitte Zahl-Holmstad is a clinical pharmacist (MPharm) working on her PhD at the Hospital Pharmacy of North Norway Trust and at UiT the Arctic University of Norway, Tromsø. Her research is conducted within the PharmED-study, and involves patient interviews and completeness of medication information.

Renata Vesela Holis

Renata Vesela Holis is a clinical pharmacist (MPharm) and researcher (PhD) working with her PostDoc within the PharmED-study. Her research uses work observation method by activity timing (WOMBAT) to see how ED workflow changes with the introduction of pharmacists.

Eirik Hugaas Ofstad

Eirik Hugaas Ofstad is a physician (MD) and researcher (PhD) working as chief consultant in the Emergency Department of Nordland Hospital Trust and as associate professor at UiT the Arctic University of Norway. He is experienced within qualitative research and research within the field of emergency medicine.

Beate Hennie Garcia

Beate Hennie Garcia is a pharmacist (MPharm) and researcher (PhD) working as an associate professor at UiT the Arctic University of Norway, Tromsø. Her research centers around how to increase appropriate use of medications, both related to the patient, the prescriber, the interdisciplinary team, and the communication. She is experienced within qualitative research.