Patient characteristics 1,2
|
Presenting complaint or
pathology |
|
Age of patient |
|
Wishes of family |
|
Adherence |
Drug characteristics 1,2
|
Clinical picture informing
prescribing decisions |
|
Avoiding harm |
|
Polypharmacy |
|
Drawing upon guidelines as resource (e.g. NICE) |
|
Iatrogenesis |
|
Review / lack of review of medication |
Pharmacist factors 1,2
|
Pharmacist as checker and
optimiser, not clinical decision maker |
|
Expertise |
Trustworthiness 1,2
|
Distrust of information source
until proved correct / reconciled |
|
Doctors compared with pharmacists and vice-versa |
|
Perception that junior doctors may not have enough experience to
review drugs |
Marketing effects 2
|
Not overtly observed in verbatim
transcripts |
Reliability of medication history (written and verbal)
1
|
Confidence in obtaining accurate history
Filling in knowledge gaps from collateral sources
Availability & functionality of Electronic Prescribing &
Administration System / use of decision support tools
Language ambiguity
|
External pressures & priorities1
|
Time-consuming
aspects of job |
|
Pressure to expedite ‘take home’ prescription on
discharge |
|
Coping strategies in response to demands on workload |
Responsibilities of prescribers1
|
Reluctance to
change medicines perceived not to be associated with cause of
admission |
|
Passing the buck. Perception that GP (not self) is responsible for
prescribing drugs that were originated in primary care
setting |