Hendrik T. Ensing|Clementine C. M. Stuijt|Bart J F van den Bemt|Ad A. van Dooren|Fatma Karapinar?Çarkit|Ellen S. Koster|Marcel L. Bouvy
Identifying the Optimal Role for Pharmacists in Care Transitions: A Systematic Review
Utrecht University|Sint Maartenskliniek|Radboud University Nijmegen|Radboud University Medical Center|University of Applied Sciences Utrecht|Utrecht University|Sint Lucas Andreas Hospital|Pharmo Institute|Pharmo Institute
background transition one health care setting another increases risk medication errors several strategies applied improve care transitions reduce adverse clinical outcomes pharmacist intervention hospitalization frequently studied show variable effect outcomes objective identify components pharmacist intervention improve clinical outcomes care transitions methods medline embase international pharmaceutical abstracts web science databases searched randomized controlled trials rcts studied pharmacist intervention regard hospitalization two reviewers independently screened references published inception november 2014 extracted data assessed risk bias results total 30 studies met inclusion criteria model created categorize cluster components pharmacist intervention average number components deployed stages hospitalization covered intervention targets equally distributed effective ineffective studies best evidence synthesis 15 studies revealed strong evidence clinical medication review multifaceted programs 5 effective vs 0 ineffective studies conflicting evidence found isolated postdischarge intervention admission medication reconciliation combining postdischarge interventions inhospital interventions covering multiple stages closely collaborating health care providers enhanced effectiveness conclusions although need welldesigned wellreported rcts study heterogeneity enabled best evidence synthesis elucidate effective components pharmacist intervention isolated postdischarge intervention programs evidence tends towards collaborating nurses tailoring individual patient needs multifaceted intervention programs performing medication reconciliation alone insufficient reducing postdischarge clinical outcomes combined active patient counseling clinical medication review furthermore close collaboration pharmacists physicians beneficial finally important secure continuity care integrating pharmacists multifaceted programs across health care settings ultimately pharmacists need know patient clinical background previous hospital experience