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dc.contributor.authorKempen, Thomas G. H.
dc.contributor.authorGillespie, Ulrika
dc.contributor.authorFärdborg, Maria
dc.contributor.authorMcIntosh, Jennifer
dc.contributor.authorMair, Alpana
dc.contributor.authorStewart, Derek C.
dc.date.accessioned2019-01-08T10:20:03Z
dc.date.available2019-01-08T10:20:03Z
dc.date.issued2018-12-19en
dc.identifier.citationKEMPEN, T.G.H., GILLESPIE, U., FÄRDBORG, M., MCINTOSH, J., MAIR, A. and STEWART, D. A case study of the implementation and sustainability of medication reviews in older patients by clinical pharmacists. Research in social and administrative pharmacy [online], In Press. Available from: https://doi.org/10.1016/j.sapharm.2018.12.006en
dc.identifier.issn1551-7411en
dc.identifier.issn1934-8150en
dc.identifier.urihttp://hdl.handle.net/10059/3252
dc.description.abstractBackground : Medication reviews have been introduced as healthcare interventions to decrease inappropriate polypharmacy in older patients, but implementation in practice is challenging. Objective: This case study aimed to explore the events, actions and other factors that were involved in the implementation and sustainability of medication reviews in older patients by clinical pharmacists in Region Uppsala, Sweden. Methods: A case study design informed by change management principles (Kotter) and normalization process theory, consisting of a review of published and grey literature, key informant interviews and focus group triangulation. Findings from additional literature review and interviews were integrated into a final thematic analysis. Ten healthcare professionals, managers and policy makers participated as key informants. The study included data up to 2015. Results : Factors were identified across all Kotter's principles and normalization process theory domains, ranging from the first evidence on inappropriate polypharmacy in the 1980s until the creation of permanent clinical pharmacist positions in recent years. Examples of facilitating factors were a national focus on quality of care for the elderly, multiprofessional teamwork, key individuals of different professions, education, financial support and local evidence. Barriers included an unclear allocation of tasks and responsibilities, a lack of time and continuity, and a lack of a national plan for implementation, monitoring and evaluation. Conclusions : Multiple factors across the full range of change management and implementation principles were involved in the implementation and sustainability. A systems approach, including these factors, should be considered in similar future initiatives, both in Sweden and settings in other countries.en
dc.description.sponsorshipSIMPATHY (663082) ; European Commission CHAFEA Health Program.en
dc.language.isoengen
dc.publisherElsevieren
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/4.0en
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectImplementation researchen
dc.subjectChange managementen
dc.subjectMultiprofessional teamsen
dc.subjectMedication managementen
dc.subjectClinical pharmacyen
dc.subjectCase studyen
dc.titleA case study of the implementation and sustainability of medication reviews in older patients by clinical pharmacists.en
dc.typeJournal articlesen
dc.publisher.urihttps://doi.org/10.1016/j.sapharm.2018.12.006en
dcterms.dateAccepted2018-12-18en
refterms.accessExceptionNAen
refterms.dateDeposit2019-01-08en
refterms.dateEmbargoEnd2019-12-19en
refterms.dateFCA2019-12-19en
refterms.dateFCD2019-01-08en
refterms.dateFreeToDownload2019-12-19en
refterms.dateFreeToRead2019-12-19en
refterms.dateToSearch2019-12-19en
refterms.depositExceptionNAen
refterms.panelAen
refterms.technicalExceptionNAen
refterms.versionAMen
rioxxterms.publicationdate2018-12-19en
rioxxterms.typeJournal Article/Reviewen
rioxxterms.versionAMen


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