Duncan McNab|Paul Bowie|Alastair Ross|Gordon MacWalter|Mary Morgan Ryan|Jill Morrison
Systematic review and meta-analysis of the effectiveness of pharmacist-led medication reconciliation in the community after hospital discharge
University of Glasgow|NHS Education for Scotland|Directorate of Health|University of Glasgow|NHS Education for Scotland|Directorate of Health|University of Dental Medicine|University of Glasgow|NHS Education for Scotland|Directorate of Health|NHS Education for Scotland|Directorate of Health|University of Glasgow
pharmacists completion medication reconciliation community hospital discharge intended reduce harm due prescribed omitted medication increase healthcare efficiency effectiveness approach clear systematically review literature evaluate intervention effectiveness terms discrepancy identification resolution clinical relevance resolved discrepancies healthcare utilisation including readmission rates emergency department attendance primary care workloadthis systematic literature review metaanalysis extracted data medline cumulative index nursing allied health literature cinahl embase allied complementary medicine database amededucation resources information center eric scopus nhs evidence cochrane databases searched using combination medical subject heading terms freetext search terms controlled studies evaluating pharmacistled medication reconciliation community hospital discharge included study quality appraised using critical appraisal skills programme evidence assessed metaanalysis readmission rates discrepancy identification rates emergency department attendance primary care workload assessed narrativelyfourteen studies included comprising five randomised controlled trials six cohort studies three prepost intervention studies twelve studies moderate high risk bias increased identification resolution discrepancies demonstrated four studies evaluated reduction clinically relevant discrepancies reported two studies metaanalysis demonstrate significant reduction readmission rate consistent evidence reduction emergency department attendance primary care workloadpharmacists identify resolve discrepancies completing medication reconciliation hospital discharge patient outcome care workload improvements consistently seen future research examine clinical relevance discrepancies potential benefits reducing healthcare team workload