Qualitative study identifies factors shaping medication management during emergency department-to-home transitions

A qualitative study at a secondary care teaching hospital identified system-, provider- and patient-level factors that can hinder medication management when patients move from the emergency department to home. The study, published in BMC Health Services Research, involved physicians, nurses, clinical pharmacists and patient representatives at a hospital managing approximately 161,000 emergency department visits annually.

Researchers recruited participants over two months through purposive and snowball sampling. They collected data through semi-structured interviews and profession-specific focus groups, transcribed the interviews verbatim and analyzed them using a hybrid inductive–deductive approach informed by the Theoretical Domains Framework. Of the 27 individuals invited, 23 participated, an 85% response rate: 19 were healthcare professionals and four were patient representatives, including patients and members of the hospital’s Patient and Family Advisory Council.

The reported barriers spanned multiple levels. System-level factors included workflow demands, resource and structural gaps, and poorly integrated care-transition and communication pathways. Provider-level factors included gaps in skills and expertise, ambiguity about professional roles, and competing priorities. Patient-level factors included communication and engagement barriers and challenges with medication adherence. Most barriers were mapped to five Theoretical Domains Framework domains: Environmental Context and Resources, Social/Professional Role and Identity, Knowledge, Skills, and Social Influences. Together, these barriers impeded medication reconciliation, patient education and post-discharge care coordination.

The study’s findings support considering multifaceted approaches that optimize discharge processes, strengthen care coordination and communication, promote interprofessional collaboration, and help patients navigate care after emergency department discharge. These are proposed potential solutions rather than interventions whose effectiveness was tested. The findings are bounded by the qualitative design, the 23-person sample and the focus on stakeholders at one hospital. The supplied evidence is an abstract reporting interview and focus-group findings; it does not establish how frequently the identified barriers occurred or whether any specific intervention improved medication management. The article was made available as an early peer-reviewed version on 16 October 2026 and was described as subject to further edits before replacement by the final Version of Record.

Subject of Research: Factors influencing medication management during emergency department-to-home transitions

Article Title: Factors influencing medication management during emergency department-to-home transitions: a qualitative study using the theoretical domains framework

Article References: Al Hmoud, E., Barazi, R., Thomas, B., Pathan, S., Nazar, H., Ibrahim, M. I. M., & Hadi, M. A. (2026). Factors influencing medication management during emergency department-to-home transitions: a qualitative study using the theoretical domains framework. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15733-2

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15733-2

Keywords: emergency department, care transitions, medication management, medication reconciliation, patient education, discharge planning, clinical pharmacists, interprofessional collaboration, qualitative study, Theoretical Domains Framework, Factors, influencing