ArticleInternational journal of clinical pharmacy2014
Effect of clinical pharmacist intervention on medication discrepancies following hospital discharge.
Article in International journal of clinical pharmacy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00513903 (Enhanced Continuity of Pharmacy Care for Cardiovascular or Pulmonary Diseases), which is not on this map. Cited by 36 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Enhanced Continuity of Pharmacy Care for Cardiovascular or Pulmonary Diseases
Who cites it
36 citing papers in PubMed, 6 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- Bridging the Gap: Systematic Review of Strategies to Facilitate Post-Discharge Continuity of In-Hospital Medication Changes in Older Adults.Drugs & aging · 2026Pooled it
- Discharge planning from hospital.The Cochrane database of systematic reviews · 2022Pooled it
- Reducing medication errors for adults in hospital settings.The Cochrane database of systematic reviews · 2021Pooled it
- Impact of medication reconciliation for improving transitions of care.The Cochrane database of systematic reviews · 2018Pooled it
- Pooled it
- Discharge planning from hospital.The Cochrane database of systematic reviews · 2016Pooled it
- A randomised trial of pharmacist-led discharge prescribing in an Australian geriatric evaluation and management service.International journal of clinical pharmacy · 2021Trial
- The effect of inpatient pharmaceutical care on nephrotic syndrome patients after discharge: a randomized controlled trial.International journal of clinical pharmacy · 2020Trial
- The effect of a pharmacy-led transitional care program on medication-related problems post-discharge: A before-After prospective study.PloS one · 2019Trial
- Pharmacotherapy problems in cardiology patients 30 days post discharge from a tertiary hospital in Brazil: a randomized controlled trial.Clinics (Sao Paulo, Brazil) · 2019Trial
- Impact of medication reconciliation and review and counselling, on adverse drug events and healthcare resource use.International journal of clinical pharmacy · 2018Trial
- Effect of a care transition intervention by pharmacists: an RCT.BMC health services research · 2014Trial
- Pharmacist-led interventions at hospital discharge: a scoping review of studies demonstrating reduced readmission rates.International journal of clinical pharmacy · 2025Article
- Quality of care transition, patient safety incidents, and patients' health status: a structural equation model on the complexity of the discharge process.BMC health services research · 2024Article
- A quality improvement study on the effect of electronic transmission of a basic discharge medication report on medication discrepancies in patients discharged from the hospital.International journal of clinical pharmacy · 2024Article
- Primary care electronic medication record discrepancies in patients starting treatment at a hospital-based ambulatory care pharmacy and impact on prevalence of potential drug-drug interactions.European journal of hospital pharmacy : science and practice · 2023Article
- Pharmacist-Led Discharge Transitions of Care Interventions for Pediatric Patients: A Narrative Review.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2023Article
- RETRACTED: An Overview of Antimicrobial Stewardship Optimization: The Use of Antibiotics in Humans and Animals to Prevent Resistance.Antibiotics (Basel, Switzerland) · 2022Review
- Community Pharmacists' Experiences and Perception about Transitions of Care from Hospital to Home in a Midwestern Metropolis.Pharmacy (Basel, Switzerland) · 2021Article
- Significance of a clinical pharmacist-led comprehensive medication management program for hospitalized oncology patients.International journal of clinical pharmacy · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundMedication discrepancies may occur at transitions in care and negatively impact patient outcomes.
objectiveTo determine if involving clinical pharmacists in hospital care, medication reconciliation and discharge medication plan communication can reduce medication discrepancies with a prospective, randomized, blinded, controlled trial.
settingA large, tertiary care, academic medical center.
methodThe intervention consisted of clinical pharmacist medication reconciliation, patient education and improved communication of the discharge medication plan, as devised by the hospital physician and care team, to primary care physicians and community pharmacists. Medication discrepancies were identified by blinded research pharmacists who reviewed primary care physician and pharmacy records at discharge through 90 days post-discharge to create 30- and 90-day medication lists.
main outcome measureRate of medication discrepancies compared across groups.
resultsA total of 592 subjects from internal medicine, family medicine, cardiology and orthopedic services were evaluated for this study. Clinically important medication discrepancies in the primary care physician record were different between groups 30 days after hospital discharge following a clinical pharmacist's intervention. The mean number of medication discrepancies per patient for the enhanced group being nearly half the number in the control group. However, this effect did not persist to 90 days post-discharge and did not extend to community pharmacy records.
conclusionThe present study demonstrates the involvement of pharmacists in hospital care, medication reconciliation and discharge medication plan communication may affect the quality of the outpatient medical record.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.