A Quality Use of Medicines program for continuity of care in therapeutics from hospital to community

Abstract

Objective: To evaluate adherence to an agreed minimum dataset for patient medication information exchange between hospitals and general practitioners. Design: Quasi pre–post design with a supplementary post‐program comparison group; sequential descriptive surveys of patients following recent discharge from public hospitals; opinion questionnaire for key hospital informants; stakeholder forum to review data and Quality Use of Medicines (QUM) action plans between pre‐ and post‐program surveys. Participants and setting: GPs and hospitals from the South East Area Health Service, Sydney. During 2000–2001, 81/124 GPs (65%) returned 147 patient questionnaires in initial follow‐up; 88/119 GPs (74%) returned 131 questionnaires in final follow‐up; a supplementary group of 54/120 GPs (45%) returned 66 questionnaires; 32/45 (71%) of nominated key informants responded to the hospital survey. Results: Direct notification of GPs by hospitals of their patient's admission was unchanged from the initial level of 22%. The proportion of GPs providing medication information to the hospital increased from 38% to 51% at Stage 2 (P < 0.05) and remained at 52% at Stage 3. The proportion of GPs receiving discharge summaries directly (initially 2%) increased to 26% at Stage 2 (P < 0.001) and remained at 27% at Stage 3. Conclusions: System change is slow to occur, but changes that are implemented are maintained. The stakeholder forum suggested that a specific person should be responsible for GP liaison.