Journal of Primeasia
Multidisciplinary research and review journal | Online ISSN 3064-9870
  1. You are here:
  2. Home
  3. Journals
  4. Biological Sciences
REVIEWS   (Open Access)
Contents Vol 3 (1)

Enhancing Medication Safety and Care Transitions: A Systematic Review of Roles and Strategies in Healthcare Settings

Faisal Fahd Misfer Al-Qahtani 1*, Turki Mohammed Al-Turaiki 1, Sultan Safah A Alharbi 1, Abdalurhman Abdulaziz Almubarak 1, Ahmad Ayad M Αναζι 1, abdullah marzouq alotaibai 1, Adil Mubarak Alotaibi 1, Saleh Kaytab Alshammari 1, Bandar Khalid Suwailem Albaqami 1, Fahad Abdulaziz Altuwaijri 1, Badr Talhab Ayed Al-Anzi 1, ‏Mohammed Ahmed Bahanshel 1

+ Author Affiliations

Journal of Primeasia 3 (1) 1-8 https://doi.org/10.25163/primeasia.3110077

Submitted: 15 November 2021 Revised: 10 January 2022  Published: 11 January 2022 

Abstract

Background: Medication reconciliation is a critical process for ensuring patient safety during transitions of care, particularly in preventing medication discrepancies that can lead to adverse events. Various healthcare professionals, including physicians, pharmacists, and nurses, play pivotal roles in this process. Studies highlight challenges and barriers in medication reconciliation, such as unclear role allocation, insufficient collaboration, and a lack of knowledge. Methods: A systematic review of existing literature was conducted, including studies from databases such as PubMed and Scopus, to assess the roles of healthcare professionals in medication reconciliation, identify discrepancies, and evaluate strategies to improve this process. Inclusion criteria focused on studies related to medication reconciliation during transitions of care, particularly in hospital settings, and involving interdisciplinary teams. Results: The findings revealed that physicians, pharmacists, and nurses have distinct but overlapping responsibilities in medication reconciliation. Pharmacists were identified as essential in managing medication discrepancies, while nurses contributed significantly to communication and patient education. However, barriers such as role ambiguity, inadequate training, and lack of interprofessional collaboration hindered the effectiveness of the process. Successful strategies included structured medication reconciliation protocols, clear role definitions, and the involvement of pharmacists in routine transitions of care. Conclusion: Medication reconciliation is a crucial component of safe transitions of care, requiring the collaboration of multiple healthcare professionals. To enhance its effectiveness, role clarity, improved communication, and interprofessional education are essential. Future research should focus on refining these strategies and evaluating their impact on patient outcomes, particularly in reducing readmissions and improving medication safety.

Keywords: Medication Reconciliation, Care Transitions, Pharmacist Involvement, Patient Safety, Healthcare Collaboration

References

Aase, K., Laugaland, K. A., Dyrstad, D. N., & Storm, M. (2013). Quality and safety in transitional care of the elderly: The study protocol of a case study research design (Phase 1). BMJ Open, 3, 8.

Albert, N. M. (2016). A systematic review of transitional-care strategies to reduce rehospitalization in patients with heart failure. Heart & Lung, 45(2), 100–113. https://doi.org/10.1016/j.hrtlng.2015.10.004

Al-Hashar, A., Al-Zakwani, I., Eriksson, T., & Al Za'abi, M. (2017). Whose responsibility is medication reconciliation: Physicians, pharmacists or nurses? A survey in an academic tertiary care hospital. Saudi Pharmaceutical Journal, 25(1), 52–58. https://doi.org/10.1016/j.jsps.2015.04.003

Almanasreh, E., Moles, R., & Chen, T. F. (2016). The medication reconciliation process and classification of discrepancies: A systematic review. British Journal of Clinical Pharmacology, 82(3), 645–658. https://doi.org/10.1111/bcp.12998

Amaniyan, S., Ghobadi, A., & Vaismoradi, M. (2020). Cold application on bruising at the subcutaneous heparin injection site: A systematic review and meta-analysis. SAGE Open Nursing, 6, 2377960820901370. https://doi.org/10.1177/2377960820901370

Bethishou, L., Herzik, K., Fang, N., Abdo, C., & Tomaszewski, D. M. (2020). The impact of the pharmacist on continuity of care during transitions of care: A systematic review. Journal of the American Pharmacists Association, 60(1), 163–177.e162. https://doi.org/10.1016/j.japh.2019.08.003

Camicia, M., & Lutz, B. J. (2016). Nursing’s role in successful transitions across settings. Stroke, 47(11), e246–e249.

Chan, C., Woo, R., Seto, W., Pong, S., Gilhooly, T., & Russell, J. (2015). Medication reconciliation in pediatric cardiology performed by a pharmacy technician: A prospective cohort comparison study. Canadian Journal of Hospital Pharmacy, 68(1), 8–15. https://doi.org/10.4212/cjhp.v68i1.1417

Chhabra, A., Quinn, A., & Ries, A. (2019). Evaluation of time spent by pharmacists and nurses based on the location of pharmacist involvement in medication history collection. Journal of Pharmacy Practice, 32(4), 394–398. https://doi.org/10.1177/0897190018793470

Chhabra, P. T., Rattinger, G. B., Dutcher, S. K., Hare, M. E., Parsons, K. L., & Zuckerman, I. H. (2012). Medication reconciliation during the transition to and from long-term care settings: A systematic review. Research in Social and Administrative Pharmacy, 8(1), 60–75.

Choo, J., Hutchinson, A., & Bucknall, T. (2010). Nurses’ role in medication safety. Journal of Nursing Management, 18(7), 853–861.

Cole, J., Wilkins, N., Moss, M., Fu, D., Carson, P., & Xiong, L. (2019). Impact of pharmacist involvement on telehealth transitional care management (TCM) for high medication risk patients. Pharmacy (Basel), 7(4).

Corbett, C. F., Setter, S. M., Daratha, K. B., Neumiller, J. J., & Wood, L. D. (2010). Nurse-identified hospital to home medication discrepancies: Implications for improving transitional care. Geriatric Nursing, 31(3), 188–196.

Dempsey, J., Gillis, C., Sibicky, S., et al. (2018). Evaluation of a transitional care pharmacist intervention in a high-risk cardiovascular patient population. American Journal of Health-System Pharmacy, 75(17 Supplement 3), S63–S71.

Donald, F., Kilpatrick, K., Reid, K., et al. (2015). Hospital to community transitional care by nurse practitioners: A systematic review of cost-effectiveness. International Journal of Nursing Studies, 52(1), 436–451.

Ensing, H. T., Stuijt, C. C., van den Bemt, B. J., et al. (2015). Identifying the optimal role for pharmacists in care transitions: A systematic review. Journal of Managed Care & Specialty Pharmacy, 21(8), 614–636. https://doi.org/10.18553/jmcp.2015.21.8.614

EQUATOR Network. (2019). Enhancing the quality and transparency of health research. Retrieved from http://www.equator-network.org

Fox, M. T., Butler, J. I., Sidani, S., et al. (2020). Collaborating with healthcare providers to understand their perspectives on a hospital-to-home warning signs intervention for rural transitional care: Protocol of a multimethod descriptive study. BMJ Open, 10(4), e034698.

Gunadi, S., Upfield, S., Pham, N.-D., Yea, J., Schmiedeberg, M. B., & Stahmer, G. D. (2015). Development of a collaborative transitions-of-care program for heart failure patients. American Journal of Health-System Pharmacy, 72(13), 1147–1152.

Hawker, S., Payne, S., Kerr, C., Hardey, M., & Powell, J. (2002). Appraising the evidence: Reviewing disparate data systematically. Qualitative Health Research, 12(9), 1284–1299. https://doi.org/10.1177/104973202129120474

Hellström, L. M., Bondesson, Å., Höglund, P., & Eriksson, T. (2012). Errors in medication history at hospital admission: Prevalence and predicting factors. BMC Clinical Pharmacology, 12, 9.

Huynh, C., Wong, I. C., Tomlin, S., et al. (2013). Medication discrepancies at transitions in pediatrics: A review of the literature. Paediatric Drugs, 15(3), 203–215.

Jencks, S. F., Williams, M. V., & Coleman, E. A. (2009). Rehospitalizations among patients in the Medicare fee-for-service program. New England Journal of Medicine, 360(14), 1418–1428.

Jordan, S., Logan, P. A., Panes, G., Vaismoradi, M., & Hughes, D. (2018). Adverse drug reactions, power, harm reduction, regulation and the ADRe profiles. Pharmacy (Basel), 6(3), 56. https://doi.org/10.3390/pharmacy6030056

Kapoor, A., Field, T., Handler, S., et al. (2019). Adverse events in long-term care residents transitioning from hospital back to nursing home. JAMA Internal Medicine, 179(9), 1254–1261.

Krivanek, M. J., Dolansky, M. A., Kukla, A., et al. (2019). Perspectives from academic and practice leaders on nursing student’s education and role in medication reconciliation. Journal of Professional Nursing, 35(2), 75–80. https://doi.org/10.1016/j.profnurs.2018.10.003

Kwan, J. L., Lo, L., Sampson, M., & Shojania, K. G. (2013). Medication reconciliation during transitions of care as a patient safety strategy: A systematic review. Annals of Internal Medicine, 158(5 Pt 2), 397–403. https://doi.org/10.7326/0003-4819-158-5-201303050-00002

Lee, K. H., Low, L. L., Allen, J., et al. (2015). Transitional care for the highest risk patients: Findings of a randomized control study. International Journal of Integrated Care, 15, e039.

Lee, K. P., Hartridge, C., Corbett, K., Vittinghoff, E., & Auerbach, A. D. (2015). "Whose job is it, really?" Physicians’, nurses’, and pharmacists’ perspectives on completing inpatient medication reconciliation. Journal of Hospital Medicine, 10(3), 184–186. https://doi.org/10.1002/jhm.2379

Lovelace, D., Hancock, D., Hughes, S. S., et al. (2016). Care case management program: Taking case management to the streets and beyond. Professional Case Management, 21(6), 277–290. https://doi.org/10.1097/NCM.0000000000000190

Manias, E., Gerdtz, M., Williams, A., & Dooley, M. (2015). Complexities of medicines safety: Communicating about managing medicines at transition points of care across emergency departments and medical wards. Journal of Clinical Nursing, 24(1–2), 69–80. https://doi.org/10.1111/jocn.12671

Naylor, M. D., Aiken, L. H., Kurtzman, E. T., Olds, D. M., & Hirschman, K. B. (2011). The care span: The importance of transitional care in achieving health reform. Health Affairs (Millwood), 30(4), 746–754.

Otsuka, S., Smith, J. N., Pontiggia, L., Patel, R. V., Day, S. C., & Grande, D. T. (2019). Impact of an interprofessional transition of care service on 30-day hospital reutilizations. Journal of Interprofessional Care, 33(1), 32–37. https://doi.org/10.1080/13561820.2018.1495246

Polinski, J. M., Moore, J. M., Kyrychenko, P., et al. (2016). An insurer’s care transition program emphasizes medication reconciliation, reduces readmissions, and costs. Health Affairs (Millwood), 35(7), 1222–1229.

Prusaczyk, B., Fabbre, V., Morrow-Howell, N., & Proctor, E. (2020). Understanding transitional care provided to older adults with and without dementia: A mixed methods study. International Journal of Care Coordination, 23(1), 14–23. https://doi.org/10.1177/2053434519899735

Redmond, P., Grimes, T. C., McDonnell, R., Boland, F., Hughes, C., & Fahey, T. (2018). Impact of medication reconciliation for improving transitions of care. Cochrane Database of Systematic Reviews, 8(8), Cd010791.

Reidt, S. L., Holtan, H. S., Larson, T. A., et al. (2016). Interprofessional collaboration to improve discharge from skilled nursing facility to home: Preliminary data on postdischarge hospitalizations and emergency department visits. Journal of the American Geriatrics Society, 64(9), 1895–1899. https://doi.org/10.1111/jgs.14207

Rennke, S., & Ranji, S. R. (2015). Transitional care strategies from hospital to home: A review for the neurohospitalist. Neurohospitalist, 5(1), 35–42.

Riordan, C. O., Delaney, T., & Grimes, T. (2016). Exploring discharge prescribing errors and their propagation post-discharge: An observational study. International Journal of Clinical Pharmacy, 38(5), 1172–1181.

Setter, S. M., Corbett, C. F., & Neumiller, J. J. (2012). Transitional care: Exploring the home healthcare nurse’s role in medication management. Home Healthcare Nurse, 30(1), 19–26.

Smith, M. (2016). Transitional care clinics: An innovative approach to reducing readmissions, optimizing outcomes and improving the patient’s experience of discharge care—conducting a feasibility study. Journal of Nursing Education and Practice, 6(6), 34. https://doi.org/10.5430/jnep.v6n6p34

Spinewine, A., Claeys, C., Foulon, V., & Chevalier, P. (2013). Approaches for improving continuity of care in medication management: A systematic review. International Journal for Quality in Health Care, 25(4), 403–417.

Storm, M., Schulz, J., & Aase, K. (2018). Patient safety in transitional care of the elderly: Effects of a quasi-experimental interorganizational educational intervention. BMJ Open, 8(1), e017852.

Tam, V. C., Knowles, S. R., Cornish, P. L., Fine, N., Marchesano, R., & Etchells, E. E. (2005). Frequency, type, and clinical importance of medication history errors at admission to hospital: A systematic review. Canadian Medical Association Journal, 173(5), 510–515.

Tjia, J., DeSanto-Madeya, S., Mazor, K. M., et al. (2019). Nurses' perspectives on family caregiver medication management support and deprescribing. Journal of Hospital Palliative Nursing, 21(4), 312–318. https://doi.org/10.1097/NJH.0000000000000572

Tsilimingras, D., & Bates, D. W. (2008). Addressing postdischarge adverse events: A neglected area. Joint Commission Journal on Quality and Patient Safety, 34(2), 85–97.

Tsilimingras, D., Schnipper, J., Duke, A., et al. (2015). Post-discharge adverse events among urban and rural patients of an urban community hospital: A prospective cohort study. Journal of General Internal Medicine, 30(8), 1164–1171.

Vaismoradi, M., Vizcaya-Moreno, F., Jordan, S., Gåre Kymre, I., & Kangasniemi, M. (2020). Disclosing and reporting practice errors by nurses in residential long-term care settings: A systematic review. Sustainability, 12(7), 2376. https://doi.org/10.3390/su12072376

van Sluisveld, N., Zegers, M., Natsch, S., & Wollersheim, H. (2012). Medication reconciliation at hospital admission and discharge: Insufficient knowledge, unclear task reallocation and lack of collaboration as major barriers to medication safety. BMC Health Services Research, 12, 170. https://doi.org/10.1186/1472-6963-12-170

Vaughn, S., Mauk, K. L., Jacelon, C. S., et al. (2016). The competency model for professional rehabilitation nursing. Rehabilitation Nursing, 41(1), 33–44. https://doi.org/10.1002/rnj.274

Vogelsmeier, A. (2014). Identifying medication order discrepancies during medication reconciliation: Perceptions of nursing home leaders and staff. Journal of Nursing Management, 22(3), 362–372. https://doi.org/10.1111/jonm.12101

Vogelsmeier, A., Pepper, G. A., Oderda, L., & Weir, C. (2013). Medication reconciliation: A qualitative analysis of clinicians’ perceptions. Research in Social and Administrative Pharmacy, 9(4), 419–430.

World Health Organization (WHO). (2007). Patient safety solutions preamble. WHO Collaborating Centre for Patient Safety Solutions.

World Health Organization (WHO). (2016). Transitions of care: Technical series on safer primary care. Geneva: WHO.

World Health Organization (WHO). (2019). Medication safety in transitions of care: Technical report. World Health Organization. Retrieved from https://www.who.int/publications/i/item/9789240063498

Zarif-Yeganeh, M., Rastegarpanah, M., Garmaroudi, G., Hadjibabaie, M., & Sheikh Motahar Vahedi, H. (2017). Incidence of medication discrepancies and its predicting factors in the emergency department. Iranian Journal of Public Health, 46(8), 1086–1094.

 

Abstract
Export Citation

View Dimensions


View Plumx


View Altmetric




Save
0
Citation
20
View

Share