Codesigning a pharmacist-led transition of care program in the emergency department: a qualitative participatory study
5 affiliations
- 1QU Health Sector, Qatar University, Doha, Qatar
- 2Hamad Medical Corporation, Doha, Qatar
- 3National Institute for Health Research (NIHR) Newcastle Patient Safety Research Collaboration, Newcastle University, Newcastle-Upon-Tyne, UK
- 4School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons Ireland, Dublin, Ireland
- 5Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
Abstract
Introduction: Transitions from the emergency department (ED) to home are high-risk periods for medication-related harm. Pharmacist-led interventions may improve medication safety and care continuity, however, co-designed approaches to developing such interventions remain limited.
Aim: This study aimed to co-design a pharmacist-led transition-of-care (ToC) program to improve medication management for adults discharged from the ED, with the intention of subsequently evaluating it in a pilot randomized controlled trial.
Method: A two-phase qualitative study was undertaken at a general teaching hospital in Qatar within a Participatory Health Research (PHR) framework. Phase I involved one-to-one interviews and focus groups with patients, pharmacists, physicians, and nurses. Phase II consisted of a co-design workshop with decision makers, including departmental leaders and hospital administrators, followed by structured refinement through additional stakeholder meetings and an electronic prioritization survey. Data were analyzed using an inductive-deductive approach, guided by two theoretical frameworks, the Theoretical Domains Framework and the Care Transitions Framework. Five proposed interventions were evaluated against the APEASE (Acceptability, Practicability, Effectiveness, Affordability, Safety, Equity) criteria, and identified barriers were mapped to corresponding intervention functions and implementation strategies.
Results: Phase I, comprising three focus groups with physicians (n = 6), nurses (n = 7), and clinical pharmacists (n = 6), and four interviews with two patients and two Patient and Family Advisory Council (PFAC) representatives, identified barriers, enablers, and stakeholder priorities related to medicines management that informed the Phase II co-design workshop. Stakeholders rated the five proposed interventions: discharge medication reconciliation, prescription review, patient counseling and education, pharmacist-to-pharmacist handover, and post-discharge follow-up with medication review, as highly feasible (mean 83%). All intervention components were retained due to their interdependence. Eligibility criteria for this intervention were decided as: patients discharged with new chronic diagnoses, newly prescribed high-risk medications, polypharmacy (i.e., taking ≥ 5 regular medications), and chronic disease exacerbations. A standardized workflow was co-developed, outlining patient identification and communication. Stakeholders prioritized key intervention functions and implementation strategies via structured voting.
Conclusion: The pharmacist-led transition-of-care program blueprint was co-designed using a participatory, theory-informed process. The finalized program will undergo feasibility testing through a pilot randomized controlled trial and a process evaluation.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s11096-026-02210-3.
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BibTeX
@article{alhmoud2026codesigning,
title = {{Codesigning a pharmacist-led transition of care program in the emergency department: a qualitative participatory study}},
author = {Eman Alhmoud and Raja Barazi and Binny Thomas and Almunzer Zakaria and Lubna Andraous and Rasha El Enany and Palli Valapila Abdulrouf and Sameer Pathan and Hamde Nazar and Mohamed Izham Mohamed Ibrahim and Muhammad Abdul Hadi},
journal = {International Journal of Clinical Pharmacy},
year = {2026},
month = aug,
doi = {10.1007/s11096-026-02210-3},
url = {https://doi.org/10.1007/s11096-026-02210-3},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Codesigning a pharmacist-led transition of care program in the emergency department: a qualitative participatory study
AU - Eman Alhmoud
AU - Raja Barazi
AU - Binny Thomas
AU - Almunzer Zakaria
AU - Lubna Andraous
AU - Rasha El Enany
AU - Palli Valapila Abdulrouf
AU - Sameer Pathan
AU - Hamde Nazar
AU - Mohamed Izham Mohamed Ibrahim
AU - Muhammad Abdul Hadi
PY - 2026
DA - 2026/08/14
JO - International Journal of Clinical Pharmacy
DO - 10.1007/s11096-026-02210-3
UR - https://doi.org/10.1007/s11096-026-02210-3
AB - Introduction: Transitions from the emergency department (ED) to home are high-risk periods for medication-related harm. Pharmacist-led interventions may improve medication safety and care continuity, however, co-designed approaches to developing such interventions remain limited. Aim: This study aimed to co-design a pharmacist-led transition-of-care (ToC) program to improve medication management for adults discharged from the ED, with the intention of subsequently evaluating it in a pilot randomized controlled trial. Method: A two-phase qualitative study was undertaken at a general teaching hospital in Qatar within a Participatory Health Research (PHR) framework. Phase I involved one-to-one interviews and focus groups with patients, pharmacists, physicians, and nurses. Phase II consisted of a co-design workshop with decision makers, including departmental leaders and hospital administrators, followed by structured refinement through additional stakeholder meetings and an electronic prioritization survey. Data were analyzed using an inductive-deductive approach, guided by two theoretical frameworks, the Theoretical Domains Framework and the Care Transitions Framework. Five proposed interventions were evaluated against the APEASE (Acceptability, Practicability, Effectiveness, Affordability, Safety, Equity) criteria, and identified barriers were mapped to corresponding intervention functions and implementation strategies. Results: Phase I, comprising three focus groups with physicians (n = 6), nurses (n = 7), and clinical pharmacists (n = 6), and four interviews with two patients and two Patient and Family Advisory Council (PFAC) representatives, identified barriers, enablers, and stakeholder priorities related to medicines management that informed the Phase II co-design workshop. Stakeholders rated the five proposed interventions: discharge medication reconciliation, prescription review, patient counseling and education, pharmacist-to-pharmacist handover, and post-discharge follow-up with medication review, as highly feasible (mean 83%). All intervention components were retained due to their interdependence. Eligibility criteria for this intervention were decided as: patients discharged with new chronic diagnoses, newly prescribed high-risk medications, polypharmacy (i.e., taking ≥ 5 regular medications), and chronic disease exacerbations. A standardized workflow was co-developed, outlining patient identification and communication. Stakeholders prioritized key intervention functions and implementation strategies via structured voting. Conclusion: The pharmacist-led transition-of-care program blueprint was co-designed using a participatory, theory-informed process. The finalized program will undergo feasibility testing through a pilot randomized controlled trial and a process evaluation. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s11096-026-02210-3.
SN - 2210-7703
SN - 2210-7711
ER -