Hospital Pharmacists' opinions on a risk prediction tool for medication-related harm in older people

Ahmed Hussain, Khalid Ali, J Graham Davies, Jennifer M Stevenson, Samantha Lippett, Mairead O'Malley, Nikesh Parekh, Chakravarthi Rajkumar

Research output: Contribution to journalArticlepeer-review


Older adults are particularly affected by medication-related harm (MRH) during transitions of care. There are no clinical tools predicting those at highest risk of MRH post-hospital discharge. The PRIME study (prospective study to develop a model to stratify the risk of MRH in hospitalized patients) developed and internally validated a risk-prediction tool (RPT) that provides a percentage score of MRH in adults over 65 in the eight-weeks following hospital discharge. This qualitative study aimed to explore the views of hospital pharmacists around enablers and barriers to clinical implementation of the PRIME-RPT. Ten hospital pharmacists: (band 6 (n=3); band 7 (n=2); band 8 (n=5)) participated in semi-structured interviews at the Royal Sussex County Hospital (Brighton, UK). The pharmacists were presented with five case-vignettes each with a calculated PRIME-RPT score to help guide discussion. Case-vignettes were designed to be representative of common clinical encounters. Data were thematically analysed using a 'framework' approach. Seven themes emerged in relation to the PRIME-RPT: 1. providing a medicine-prioritisation aide; 2. acting as a deprescribing alert; 3. facilitating a holistic review of patient's medication management; 4. simplifying communication of MRH to patients and the multidisciplinary team; 5. streamlining community follow-up and integration of risk discussion into clinical practice; 6. identifying barriers for the RPTs integration in clinical practice and 7. acknowledging its limitations. Hospital pharmacists found the PRIME-RPT beneficial in identifying older patients at high-risk of MRH following hospital discharge, facilitating prioritising interventions to those at highest risk while still acknowledging its limitations. [Abstract copyright: This article is protected by copyright. All rights reserved.]
Original languageEnglish
Article numberbcp.15502
Pages (from-to)672-686
Number of pages15
JournalBritish Journal of Clinical Pharmacology
Issue number2
Publication statusPublished - 20 Aug 2022

Bibliographical note

Funding Information:
We would like to acknowledge the valuable contributions of all the pharmacists who agreed to participate in the semistructured interviews. There was no funding for this research.

Publisher Copyright:
© 2022 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.


  • polypharmacy
  • frailty
  • older adults
  • risk assessment
  • medicines
  • risk prediction


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