Improving care transitions: current practice and future opportunities for pharmacists

Area of Science:

• Health Services Research
• Patient Safety
• Pharmaceutical Sciences

Background:

• Patient safety during care transitions is a growing concern, with high hospital readmission rates linked to poor transitions.
• Adverse drug events (ADEs) from complex medication regimen changes significantly contribute to readmissions.

Purpose of the Study:

• To delineate the roles and responsibilities of pharmacists in optimizing drug therapy outcomes during care transitions.
• To identify barriers and high-risk patient populations for ADEs during care transitions.
• To discuss national initiatives and models for improving care transitions with pharmacist integration.

Main Methods:

• Review of current literature and national initiatives concerning care transitions and pharmacist roles.
• Identification of pharmacist interventions such as medication reconciliation, communication, and patient assessment.
• Analysis of barriers to pharmacist involvement and recommendations for educational and systemic changes.

Main Results:

• Pharmacists are vital in preventing ADEs and readmissions through medication reconciliation, interprofessional communication, and patient education.
• Key barriers include inadequate communication, poor care coordination, and lack of defined responsibility.
• Specific patient populations are at higher risk for ADEs during transitions.

Conclusions:

• Integrating pharmacists into interdisciplinary teams and medical rounds is essential for enhancing patient safety during care transitions.
• Educational programs and accreditation standards must emphasize pharmacists' roles in care transitions.
• Addressing health literacy and exploring reimbursement models can further support pharmacist involvement and patient empowerment.