Impacts of Outsourcing Medication Repackaging in Nursing Homes: Quality and Areas of Pharmacy–Nursing Collaboration

The task of repackaging resident's medication into medication organizers is increasingly outsourced from nursing homes to pharmacies, presenting an opportunity to redefine the interaction between nursing and pharmaceutical staff. This study investigated whether outsourcing medication repackaging changes the quality and subjects of collaboration between the two professions. A cross-sectional survey was developed targeting heads of nursing in German nursing homes. A simple random sample of 1415 nursing homes was contacted by phone. Respondents participated either by phone or by online survey. Quality of collaboration was measured using Kenaszchuk's Interprofessional Collaboration Scale (ICS) with its subscales Communication, Accommodation and Isolation. Topics of interaction were ascertained using items along a medication management phase model. Differences in response frequencies were analyzed using Fisher's exact test. A total of 268 nursing homes participated (response: 18.9%). Of these, 132 (49.3%) had outsourced repackaging. Respondents at nursing homes with in-house medication repackaging rated the subscale Accommodation more favorably (<i>p</i> = 0.008), while Communication and Isolation showed no difference. Of the 13 individual ICS items, "passing on information" (Communication) was rated better by respondents at homes with outsourced repackaging (<i>p</i> = 0.019) and "consideration of convenience" (Accommodation) more favorably by respondents at homes with in-house repackaging (<i>p</i> = 0.042). Nursing staff at homes with outsourced medication repackaging interacted with pharmaceutical staff more frequently on medication changes (<i>p</i> < 0.001), but less frequently on tablet splitting (<i>p</i> = 0.035). In conclusion, outsourcing medication repackaging has a limited impact on the quality of interprofessional collaboration between the two professions but may have the potential to reduce ambiguities regarding splitting tablets.