Managing medicines-related continuity of care: the views of a range of prescribers in New Zealand general practice.

Abstract

Introduction Continuity of care is considered vital to achieving high-quality health care. Traditionally, general practitioners have played a key role in managing continuity of care and have largely been accountable for prescribing decision-making in primary care. Following prescribing legislation changes, a range of health disciplines make decisions regarding medicines in the general practice setting. To date, few studies have investigated how different prescribing disciplines view the management of medicines-related continuity of care. Understanding the views of these clinicians is important to achieving safe, effective and equitable outcomes from medicines. Aim The purpose of this study was to explore the views of general practitioners, nurse prescribers and pharmacist prescribers about their role in managing medicines-related continuity of care. Methods Qualitative, semi-structured in-depth interviews were undertaken with 16 prescribers based in eight North Island (New Zealand) general practices. Interviews were transcribed verbatim and analysed thematically using an inductive approach. Results Three key themes were identified from data analysis: a patient-focused approach; interdisciplinary teamwork; and optimising the medicine regimen. Discussion Prescribers in this study identify the important connection between continuity of care and achieving good outcomes from medicines. Good patient-prescriber relationships and ongoing interdisciplinary relationships across all health settings are considered essential to medicines-related continuity of care. Prescribers experience challenges associated with increasing multimorbidity, medicines complexities and fragmentation of clinical records.