Abstract
Background:
Despite documentation of the need for and benefit of medication-related support for patients who have been discharged from hospital, such support is not consistently available. This gap in care represents an opportunity for community pharmacists.
Objective:
To detail the types of drug-related issues identified for patients after discharge from hospital.
Methods:
The study entailed review of medication assessments performed by a Medication Management Program pharmacist for patients discharged from a community hospital over a 1-year period, in order to identify the number and type of drug-related problems, the number of discrepancies and the medications most commonly implicated in these problems.
Results:
Records were reviewed for 110 patients discharged during the study period. For these patients, the pharmacist identified a total of 259 drug-related problems (median 2 per patient) and 135 medication discrepancies (median 1 per patient) shortly after discharge. The most commonly implicated medications were calcium-vitamin D supplements, acetylsalicylic acid, furosemide and ramipril.
Conclusion:
With information about the types of drug-related problems and discrepancies commonly identified for patients discharged from hospital, community pharmacists are ideally positioned to respond to this gap in care.
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