A review on interventions to reduce medication discrepancies or errors in primary or ambulatory care setting during care transition from hospital to primary care.

Introduction: Transition of care from hospital to primary care has been associated with increased medication errors. This review article aims to examine the existing evidence on interventions to reduce medication discrepancies or errors in primary or ambulatory care setting during care transition from hospital to primary care.

Methods: We systematically reviewed the articles in primary or ambulatory care setting on patients with care transition that involved medication safety, discrepancy, or error as outcome assessment. Primary research articles were selected. Interventions in nursing homes or long-term care facilities were excluded from the review.

Results: We found 6 articles that met the inclusion criteria and 4 are prospective cohort study. The key players were pharmacists, nurse, and primary care physician. The interventions included care communication, medication reconciliation or review, and clarifying medication-related problems.

Conclusion: There is evidence that interventions in primary care setting reduce medication discrepancies on patients with the transition of care from hospital to primary care setting. Only one randomized trial involving pharmacist-led medication reconciliation was done in an outpatient setting. More good-quality randomized controlled trials should be carried out to confirm the evidence.