A systematic review of the role of community pharmacies in improving the transition from secondary to primary care

Abstract

Aim We set out to determine the potential contribution of community pharmacists to improve the transfer of care of patients from secondary to primary care settings. Method We systematically reviewed the literature on interventions that involved community pharmacy post‐discharge. We considered all relevant studies, including both randomized and non‐randomized controlled trials, irrespective of patient population. Our primary outcome was any impact on patient and medication outcomes, while the secondary outcome was to identify intervention characteristics that influenced all reported outcomes. Results We retrieved 14 studies that met our inclusion criteria. There were four studies reporting outcomes relating to the identification and rectification of medication errors that were significantly improved with community pharmacy involvement. Other patient outcomes such as medication adherence and clinical control were not unanimously positively or negatively influenced via the inclusion of community pharmacy in a transfer of care post‐discharge intervention. Some inconsistencies in implementation and process evaluation of interventions were found across the reviewed studies. This limited the accuracy with which true impact could be considered. Conclusions There is evidence that interventions including a community pharmacist can improve drug related problems after discharge. However, impact on other outcomes is not consistent. Further studies are required which include process evaluations to describe fully the context of the intervention so as to determine better any influencing factors. Also applying more stringent controls and closer adherence to protocols in both intervention and control groups would allow clearer correlations to be made between the intervention and the outcomes.

Community pharmacist perceptions of delivering post-hospital discharge Medicines Use Reviews for elderly patients

“…This report is timely in the context of a recently published systematic review of studies evaluating the role of community pharmacists in the transition of patients from secondary to primary care [8]. In this study, community pharmacists held positive opinions of the dMUR service and could see the benefit to patients regarding identification of medicine nonadherence and avoidance of medicine errors.…”

The patient pathway in cardiovascular care: A position paper from the International Pharmacists for Anticoagulation Care Taskforce (iPACT)

“…A recent systematic review highlighted how community pharmacists could help identify and rectify medication errors, thus providing a significant impact on improving outcomes . In 2012, the Royal Pharmaceutical Society (RPS) issued professional guidance in its publication “Keeping patients safe when they transfer between care providers—getting the medicines right” on the core principles that underpin the safe transfer of information related to medicines for a patient transferring between care providers in any setting…”

“…95 A recent systematic review highlighted how community pharmacists could help identify and rectify medication errors, thus providing a significant impact on improving outcomes. 96 In 2012, the Royal Pharmaceutical Society (RPS) issued professional guidance in its publication "Keeping patients safe when they transfer between care providers-getting the medicines right" on the core principles that underpin the safe transfer of information related to medicines for a patient transferring between care providers in any setting. 97 Effective interventions for minimizing medication interactions and keeping patients out of hospital have long been shown to be cost-effective, with the PINCER trial evidencing important reductions in medication misuse in various therapeutic areas, including antihypertensive medication.…”

The impact of community pharmacist involvement on transitions of care: A systematic review and meta-analysis

“…9 Furthermore, community pharmacists often develop longlasting therapeutic relationships with their patients, and they have shown increased potential to address many population health issues, such as medication-related issues during transitions in care. 10 Nazar et al 11 recently examined the impact of community pharmacists on transitions of care and found that community pharmacists can reduce the incidence of drug-related problems after discharge; however, they did not quantify the impact of community pharmacists on transitions of care. Herein, we report our findings following a systematic review of the literature of community pharmacist interventions on patients transitioning from hospital to home on 30-day readmissions, a primary outcome of patients following discharge.…”