Development of hospital pharmacy services at transition of care points: a scoping review.

BACKGROUND: Several hospital pharmacy services exist, which take place at different interfaces of patient care. Although they are an important tool for improving medication safety, they are not yet sufficiently implemented in hospitals around the world.

OBJECTIVE: This scoping review aims to summarise different hospital pharmacy services at transition of care (TOC) points in order to identify development trends and practice patterns in high-income countries over the past decade.

METHODS: A literature search of four databases (PubMed, PubPharm, Cochrane Library (Ovid) and ScienceDirect) since 2011 was conducted. A detailed search strategy was developed and refined with the help of a research librarian. Title, abstract and full-text selection was carried out by two researchers independently. The study was reported in accordance with the PRISMA-ScR items to ensure quality standard reporting. Only studies originating from developed countries and published in the English language were included. The data obtained were extracted and summarised using a data extraction form developed to meet the research aims of the study.

RESULTS: Of the 5456 search results, 65 studies met the inclusion criteria. These originated from Europe (n=29), North America/Canada (n=28), Australia (n=7) and Asia (n=1). Individual TOC services such as medication reconciliation and medication review on admission and at discharge were the main focus of published literature practice patterns between 2011 and 2016, after which a more holistic TOC service started to emerge that follows patients across all TOC points during their hospital stay. Facilitators and barriers were consistently dependent on resources and infrastructure. Clinical and economic outcomes show a mixed picture.

CONCLUSION: During the past decade pharmaceutical services have developed more holistic TOC services. Large-scale high-quality studies are needed to reliably determine clinical and economic benefit.