The developing role of community pharmacists in facilitating care transitions: A systematic review

Abstract

Background: The impact of multidisciplinary interventions to support patients moving from hospital to home have generally demonstrated a benefit. However, the role of community pharmacists is still being defined.

Objectives: To review, with the use of the Coleman Care Transitions Intervention (CTI) pillars, the interventions performed by community and ambulatory-care pharmacists for patients undergoing care transitions.

Data sources: The following databases were searched for manuscripts published from 1997 to 2017: Pubmed, Cochrane Database, Cinahl, and Embase.

Data extraction: Two authors screened manuscripts for relevancy. Studies were included if they evaluated patient care processes by community or ambulatory-care pharmacists as part of care transitions beyond receiving a discharge summary. Data were abstracted by one author and reviewed by the other.

Results: Twelve studies were included in the review, 8 of which were from the community setting. Each CTI pillar was represented, although to differing degrees. Pharmacists applied their experience in reviewing medications, identifying and resolving drug therapy problems, and providing education to this new context. Better mechanisms are needed to notify pharmacists of patients undergoing transition, grant access to medical records, and provide appropriate reimbursement. The CTI pillars of assisting patients with personal health records and discussing condition red flags were infrequently used, suggesting an area for exploration.

Conclusion: Although there are important structural barriers to address, community pharmacists are increasingly positioned to contribute to care transitions, and there are numerous interventions that can be combined when creating new programs.