Perspectives of Healthcare Professionals, Patients and Family Members on Managing Regular Medications Across the Perioperative Pathway: An Exploratory Qualitative Study.

Abstract

AIM To explore healthcare professionals', patients', and family members' experiences of managing regular medications across the perioperative pathway in a specialist cancer hospital in Melbourne. DESIGN An exploratory qualitative study using a descriptive-interpretive approach. METHODS Interviews were conducted with 11 patients and seven family members, and focus groups with 10 anaesthetists, seven surgeons, four nurses, and 10 pharmacists (N = 49) between October 2024 and April 2025. Transcripts were analysed using Braun and Clarke's reflexive thematic approach and mapped into the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 human factors framework. RESULTS Three interrelated themes were constructed: (1) Work system elements shaping perioperative medication management, encompassing medication and surgical contexts, documentation gaps, reliable medication information, communication infrastructures, roles and responsibilities, and perioperative area resources; (2) Processes influencing medication management practice, characterised by continuity of care at transition points and flagging processes, interdisciplinary collaboration and role interpretation in medication management, patient involvement, family member involvement, and healthcare professional perspectives; and (3) Outcomes of medication management, including patient and organisational outcomes, such as workflow inefficiencies, procedure cancellations, and unplanned readmissions. CONCLUSION Findings indicated that addressing the complexity of perioperative medication safety demands coordinated contributions across multiple professional disciplines. Strengthening interdisciplinary collaboration, clarifying shared responsibilities, embedding structured reconciliation processes at transitions of care, standardizing communication protocols, and involving patients and families are all critical strategies. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE This study highlights the need for interdisciplinary coordination and clear role definitions, with nurses as the key contributor, to support collaborative medication decisions in perioperative cancer care. IMPACT This study explored challenges in managing regular medications during cancer surgery, offering insights to guide safer practices for perioperative teams, patients, and families in cancer care settings. REPORTING METHOD COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines. PATIENT OR PUBLIC CONTRIBUTION None.