ArticleEuropean journal of hospital pharmacy : science and practice2020
Medicines reconciliation in primary care: a study evaluating the quality of medication-related information provided on discharge from secondary care.
Article in European journal of hospital pharmacy : science and practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 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
- Use of Electronic Patient Record Systems for Rapid Response to an MHRA Public Assessment Report: Retrospective Observational Study.JMIR formative research · 2026Observational
- The impact of collaborative pharmaceutical care on hospital discharge medication error prevalence: A stepped-wedge cluster randomised trial.Exploratory research in clinical and social pharmacy · 2025Article
- Medication information completeness in discharge summaries from a Norwegian rural hospital - a cross-sectional study.BMC health services research · 2025Article
- Pharmacist-led medication reconciliation service for patients after discharge from tertiary hospitals to primary care in Singapore: a qualitative study.BMC health services research · 2024Article
- Facilitating the transfer of care from secondary to primary care: a scoping review to understand the role of pharmacists in general practice.International journal of clinical pharmacy · 2023Article
- Exploring pharmacist involvement in the discharge medicines reconciliation process and information transfer to primary care: an observational study.International journal of clinical pharmacy · 2022Observational
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Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: Medicines reconciliation is an effective way of reducing errors at transitions of care. Much of the focus has been on medicines reconciliation at point of admission to hospital. Our objective was to evaluate medicines reconciliation after discharge from hospital by assessing the quality of information regarding medicines within discharge summaries and determining whether the information provided regarding medicines changes were acted on within 7 days of receiving the discharge information. Methods: A retrospective collaborative evaluation of medicines-related discharge information by Clinical Commissioning Group (CCG) pharmacists using standardised data collection tools. Outcomes of interest included compliance with national minimum standards for medication-related information on discharge summaries, such as allergies, changes to medication regimen, minimum prescription standards, for example, dose, route, formulation and duration, and medicines reconciliation by the primary care team. Data were analysed centrally. Results: 43 CCGs covering each of the four National Health Service regions in England participated in the study and submitted data for 1454 patients and 10 038 prescribed medicines. The majority of medication details were stated in accordance with standards with the exception of indication (11.7% compliance), formulation (60.3% compliance) and instructions of ongoing use (72.5% compliance). Documentation about changes was poor: 1550/3164 (49%) newly started medicines, 186/477 (39%) dose changes and 420/738 (57%) stopped medicines had a reason documented. Changes were not acted on within 7 days of receiving the discharge information for 12.5% of patients. Conclusions: Our evaluation revealed overall good compliance with discharge medication documentation standards, but a number of changes to medicines during hospitalisation were not fully communicated or documented on the discharge summary or actioned in the general practice after discharge.
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