Initiatives promoting seamless care in medication management: an international review of the grey literature

Claeys, Coraline; Foulon, Veerle; Winter, Sabrina De; Spinewine, Anne

doi:10.1007/s11096-013-9844-2

Cited by 16 publications

(11 citation statements)

References 28 publications

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“…An international review of regional and national initiatives relating to medicines at care transitions identified the importance of local implementation strategies in ensuring regional and national initiatives and policies work effectively. 6 This study has provided insights into how local policies can be refined.…”

Section: Resultsmentioning

confidence: 99%

Patients' knowledge of new medicines after discharge from hospital: What are the effects of hospital-based discharge counseling and community-based medicines use reviews (MURs)?

Elson

Cook

Blenkinsopp

2017

Research in Social and Administrative Pharmacy

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CitationElson R, Cook H and Blenkinsopp A (2017) Patients' knowledge of new medicines after discharge from hospital: What are the effects of hospital-based discharge counseling and communitybased medicines use reviews (MURs) medicines use after discharge from hospital. However little research has studied how this resource might be targeted.?In this study, patients were surveyed after discharge from hospital to determine their knowledge and understanding of newly-prescribed medication. Patients received either usual care (nurse counselling at discharge) or pharmacist counselling.The patients who received pharmacist counselling knew more about their new medicines.The study findings could help to more effectively target hospital pharmacist resource.Community pharmacist input was under-utilised and the study provides insights into the reasons for this. Abstract AimTo determine the effects of targeted hospital pharmacist counselling on discharge or targeted community pharmacy medicines reviews post-discharge on patients' knowledge of newly started medication. MethodControlled trial of targeted medicines discharge counselling provided by hospital pharmacists or follow-up post-discharge medicines review provided by community pharmacists compared with usual care (nurse counselling). Outcomes measured using a structured telephone survey conducted at two and four weeks after patients were discharged from hospital. ResultsPatients who received hospital pharmacist counselling were significantly more likely to report being told the purpose of their new medicine and how to take it than those receiving usual care. Fewer than half of the patients who were allocated to receive a community pharmacy medicines review did receive one. ConclusionThe study results indicate that patient knowledge of medicines newly prescribed in hospital is increased by targeted counselling by hospital pharmacists. The findings also suggest the need to improve the consistency of the information covered when providing counselling, perhaps by the implementation of a counselling checklist for use by all disciplines of staff involved in patient counselling. The potential of community pharmacy follow-up medicines reviews is currently undermined by several barriers to uptake.

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Section: Resultsmentioning

confidence: 99%

Patients' knowledge of new medicines after discharge from hospital: What are the effects of hospital-based discharge counseling and community-based medicines use reviews (MURs)?

Elson

Cook

Blenkinsopp

2017

Research in Social and Administrative Pharmacy

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“…The roles pharmacists can play in improving patient safety at care transitions are well documented [ 22 , 23 ]. Activities mainly encompass medication reconciliation [ 24 – 26 ], patient education programmes and post-discharge follow-up [ 22 , 23 , 27 – 29 ] and medication reviews [ 22 , 23 , 27 ]. By demonstrating that pharmacists can safely write discharge medication orders, the present study has expanded the evidence-base regarding pharmacist-led discharge activities.…”

Section: Discussionmentioning

confidence: 99%

The incidence and severity of errors in pharmacist-written discharge medication orders

et al. 2017

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Background Errors in discharge prescriptions are problematic. When hospital pharmacists write discharge prescriptions improvements are seen in the quality and efficiency of discharge. There is limited information on the incidence of errors in pharmacists’ medication orders. Objective To investigate the extent and clinical significance of errors in pharmacist-written discharge medication orders. Setting 1000-bed teaching hospital in London, UK. Method Pharmacists in this London hospital routinely write discharge medication orders as part of the clinical pharmacy service. Convenient days, based on researcher availability, between October 2013 and January 2014 were selected. Pre-registration pharmacists reviewed all discharge medication orders written by pharmacists on these days and identified discrepancies between the medication history, inpatient chart, patient records and discharge summary. A senior clinical pharmacist confirmed the presence of an error. Each error was assigned a potential clinical significance rating (based on the NCCMERP scale) by a physician and an independent senior clinical pharmacist, working separately. Main outcome measure Incidence of errors in pharmacist-written discharge medication orders. Results 509 prescriptions, written by 51 pharmacists, containing 4258 discharge medication orders were assessed (8.4 orders per prescription). Ten prescriptions (2%), contained a total of ten erroneous orders (order error rate—0.2%). The pharmacist considered that one error had the potential to cause temporary harm (0.02% of all orders). The physician did not rate any of the errors with the potential to cause harm. Conclusion The incidence of errors in pharmacists’ discharge medication orders was low. The quality, safety and policy implications of pharmacists routinely writing discharge medication orders should be further explored.

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“… 66 Ongoing efforts to reach truly seamless care will be strengthened with leadership, tailoring strategies to the local setting and information technology support. 19 …”

Section: Communicationmentioning

confidence: 99%

“…This has been driven mostly from the identification of these events as having an increased risk for information transfer to be suboptimal, which can lead to errors and omissions regarding medication therapy. 19 – 21 This can result in an increased risk of an ADE, which includes adverse drug reactions (ADRs) or another type of drug-related problem (DRP). Unfortunately, the evidence also shows that many of these ADEs are potentially preventable.…”

Section: Introductionmentioning

confidence: 99%

Preventing drug-related adverse events following hospital discharge: the role of the pharmacist

Nicholls¹,

MacKenzie²,

Braund³

2017

IPRP

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Transition of care (ToC) points, and in particular hospital admission and discharge, can be associated with an increased risk of adverse drug events (ADEs) and other drug-related problems (DRPs). The growing recognition of the pharmacist as an expert in medication management, patient education and communication makes them well placed to intervene. There is evidence to indicate that the inclusion of pharmacists in the health care team at ToC points reduces ADEs and DRPs and improves patient outcomes. The objectives of this paper are to outline the following using current literature: 1) the increased risk of medication-related problems at ToC points; 2) to highlight some strategies that have been successful in reducing these problems; and 3) to illustrate how the role of the pharmacist across all facets of care can contribute to the reduction of ADEs, particularly for patients at ToC points.

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Initiatives promoting seamless care in medication management: an international review of the grey literature

Abstract: Although not all initiatives are applicable as such to a particular healthcare setting, most of them convey very interesting data that should be used when drawing recommendations and implementing approaches to optimize continuity of care.

Cited by 16 publications

References 28 publications

Patients' knowledge of new medicines after discharge from hospital: What are the effects of hospital-based discharge counseling and community-based medicines use reviews (MURs)?

Patients' knowledge of new medicines after discharge from hospital: What are the effects of hospital-based discharge counseling and community-based medicines use reviews (MURs)?

The incidence and severity of errors in pharmacist-written discharge medication orders

Preventing drug-related adverse events following hospital discharge: the role of the pharmacist

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