Effects of hospital pharmacist-community pharmacist collaboration on solving pharmacotherapy problems in stroke...

Seamlessly providing appropriate drug therapy to patients recovering from stroke is essential for preventing recurrence, regardless of changes in their medical care environment. To address this, several initiatives have been undertaken to improve communication between hospital and community pharmacists, including the use of discharge medication summaries. However, we previously revealed discrepancies between the contents of prescriptions upon discharge and outpatient prescriptions from other institutions. Therefore, in the present study, we aimed to examine the effect of bidirectional information sharing between hospital pharmacists and community pharmacists, to assess the impact on prescription continuity in stroke patients.

The study included patients who received hospital treatment for stroke (cerebral infarction and transient ischemic attack) and were transferred to another hospital for outpatient treatment after discharge. The control group only received summaries, whereas in the intervention group, besides receiving summaries, patient information was shared bidirectionally between hospital pharmacists and community pharmacists through an online tool (secure messaging platform) for approximately 12 weeks post-discharge. The primary endpoint was the number of medication discrepancies resolved (the number of individual medications for which discrepancies were identified and successfully addressed, totaled across all patients), and the secondary endpoint was the percentage of prescription interventions by community pharmacists. These groups were compared using Fisher's exact test.

In the intervention group, medication discrepancies were reduced from 16 to 4 drugs, indicating the resolution of 12 discrepancies, whereas that in the control group remained the same at 13 drugs, showing no change (p = 0.0051). The percentage of prescription interventions by community pharmacists ((number of drugs with at least one intervention/number of drugs)) was 16/16 (100%) in the IG vs. 3/13 (23.1%) in the CG. This difference was statistically significant (p = 0.0003).

This study demonstrated that bidirectional information sharing between hospital pharmacists and community pharmacists promotes prescription interventions and may contribute to improving medication continuity and safety in patients recovering from stroke compared with conventional care. These findings support the implementation of pharmacist collaboration systems to reduce medication discontinuation during care transitions in stroke patients.

This trial is registered on Japan Registry of Clinical Trials (jRCT) (identifier: jRCT1050250043), June 9, 2025 (retrospectively registered).