The impact of the pharmacist on continuity of care during transitions of care: A systematic review

Bethishou, Laressa; Herzik, Kristen A.; Fang, Noah; Abdo, Connie; Tomaszewski, D.

doi:10.1016/j.japh.2019.06.020

Cited by 42 publications

(25 citation statements)

References 51 publications

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“…It is anticipated from our identified rate of error/harm that the cost of "no action taken" is high in terms of a patient's subsequent use of the healthcare services post-hospital discharge. A number of reviews have been published that evaluated interventions (including medication reconciliation, community pharmacy involvement and electronic communication interventions) to reduce MEs and ADEs post-discharge [140][141][142][143][144][145][146]. However, none have reported consistent reductions in these outcomes.…”

Section: Implications Of Findingsmentioning

confidence: 99%

Prevalence and Nature of Medication Errors and Medication-Related Harm Following Discharge from Hospital to Community Settings: A Systematic Review

2020

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Background Little is known about the epidemiology of medication errors and medication-related harm following transition from secondary to primary care. This systematic review aims to identify and critically evaluate the available evidence on the prevalence and nature of medication errors and medication-related harm following hospital discharge. Methods Studies published between January 1990 and March 2019 were searched across ten electronic databases and the grey literature. No restrictions were applied with publication language or patient population studied. Studies were included if they contained data concerning the rate of medication errors, unintentional medication discrepancies, or adverse drug events. Two authors independently extracted study data. Results Fifty-four studies were included, most of which were rated as moderate (39/54) or high (7/54) quality. For adult patients, the median rate of medication errors and unintentional medication discrepancies following discharge was 53% [interquartile range 33-60.5] (n = 5 studies) and 50% [interquartile range 39-76] (n = 11), respectively. Five studies reported adverse drug reaction rates with a median of 27% [interquartile range 18-40.5] and seven studies reported adverse drug event rates with a median of 19% [interquartile range 16-24]. For paediatric patients, one study reported a medication error rate of 66.3% and another an adverse drug event rate of 9%. Almost a quarter of studies (13/54, 24%) utilised a follow-up period post-discharge of 1 month (range 2-180 days). Drug classes most commonly implicated with adverse drug events were antibiotics, antidiabetics, analgesics and cardiovascular drugs. Conclusions This is the first systematic review to explore the prevalence and nature of medication errors and adverse drug events following hospital discharge. Targets for future work have been identified.

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Section: Implications Of Findingsmentioning

confidence: 99%

Prevalence and Nature of Medication Errors and Medication-Related Harm Following Discharge from Hospital to Community Settings: A Systematic Review

2020

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“…Pharmacist services at discharge include comprehensive medication review, assess for medication adherence and access barriers, provide discharge instructions and education, and coordinating the transmission and filling of discharge prescriptions. 35 Discharge workflow has also changed in light of the pandemic.…”

Section: Discharge Medication Reconciliationmentioning

confidence: 99%

The impact of COVID-19 on pharmacy transitions of care services

Herzik

Bethishou

2021

Research in Social and Administrative Pharmacy

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COVID-19 has necessitated alterations to the delivery of healthcare services. Modifications include those made to improve patient and healthcare worker safety such as the use of personal protective equipment. Pharmacy services, specifically pharmacy transitions of care services have not been immune to change which have brought along their own set of unique challenges to consider. This paper discusses how COVID-19 has impacted the delivery of pharmacy transitions of care services with real world examples from Sharp Grossmont Hospital and Hoag Memorial Hospital Presbyterian. Procedures implemented to minimize the spread and contraction of COVID-19 such as minimized patient contact and altered visitor policies have made it more challenging to obtain a best possible medication list the patient was taking prior to arrival to the hospital which has lead to an increased reliance on secondary sources to complete medication histories. Regarding discharge prescriptions, preference has shifted to the use of electronic vs. hard copy prescriptions, mail order, and utilization of med to bed programs and other hospital medication delivery services to limit patient contact in outpatient pharmacies. An improved effort to resolve medication acquisition issues prior to discharge utilizing patient assistance programs and other hospital programs to cover the cost of medications for COVID positive patients under certain circumstances has been seen. This paper highlights the important role pharmacists can play in providing effective communication, supporting continuity of care, and advocating for patient engagement and empowerment during transitions of care in the COVID-19 pandemic.

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“…Train professionals to be aware of the possibility of MEs occurring when the medication is in the hands of the patient or their caregivers. The role of pharmacists adds value to interventions for increasing safety (for example, warning patients about risks, identifying troubled patients with medication management) and participating as members of the health care team in deprescribing, and conciliation to reduce the complexity of treatment regimens [28]. Renewed efforts should be made considering the benefits of these interventions by reducing the possibility of errors in the home.…”

Section: What Else Could Be Done?mentioning

confidence: 99%

How to reduce medication errors in patients over the age of 65?

Mira

2021

Expert Opinion on Pharmacotherapy

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The impact of the pharmacist on continuity of care during transitions of care: A systematic review

Cited by 42 publications

References 51 publications

Prevalence and Nature of Medication Errors and Medication-Related Harm Following Discharge from Hospital to Community Settings: A Systematic Review

Prevalence and Nature of Medication Errors and Medication-Related Harm Following Discharge from Hospital to Community Settings: A Systematic Review

The impact of COVID-19 on pharmacy transitions of care services

How to reduce medication errors in patients over the age of 65?

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