Importance of the pharmacist in qualified hospital discharge: Integrative review
DOI:
https://doi.org/10.33448/rsd-v12i11.43697Keywords:
Patient discharge; Patient safety; Transition to adult care; Pharmaceutical services; Medication reconciliation.Abstract
Patient discharge is defined as the patient's departure from the hospital environment and involves care demands generated during hospitalization, such as the various drug adjustments that weaken the transfer of care to primary care, increasing the risk of Drug-Related Problems (DRPs). The pharmacist performs the prevention, detection and resolution of DRPs and positively influences the post-hospital care through his interventions, such as Medication Reconciliation (RM). The objective of this study was to identify references that demonstrate the importance of the pharmacist at the time of patient discharge and to elaborate a Standard Operating Procedure (SOP) based on the documents in order to guide the pharmaceutical conduct in the context of patient discharge and to produce didactic material that contributes to the pharmaceutical orientation inserted in a hospital institution. This is an integrative review using the PICO strategy for the guiding question, following the following descriptors: “patient discharge”, “pharmaceutical care”, “medication reconciliation” and “patient safety”. The results found in the articles demonstrate the importance of the pharmacist during hospital discharge, monitoring and avoiding DRPs, waiting for hospital readmissions and cost, providing patient safety. Thus, it is important that this professional is included in the discharge process, supervising the planning, monitoring the length of stay and ensuring the rational use of the medication.
References
Al-Hashar, A., Al-Zakwani, I., Eriksson, T., Sarakbi, A., Al-Zadjali, B., Al Mubaihsi, S., & Al Za’abi, M. (2018). Impact of medication reconciliation and review and counselling, on adverse drug events and healthcare resource use. International Journal of Clinical Pharmacy, 40(5), 1154–1164. https://doi.org/10.1007/s11096-018-0650-8
Bernardino, E., Sousa, S. M. de, Nascimento, J. D. do, Lacerda, M. R., Torres, D. G., & Gonçalves, L. S. (2022). Cuidados de transição: análise do conceito na gestão da alta hospitalar. Escola Anna Nery, 26. https://doi.org/10.1590/2177-9465-ean-2020-0435
Bonk, N., Milsap, A., Goplen, A., McElray, K., & Rabago, D. (2020). Reducing discharge delay through resident-pharmacist colocation: A pilot study. Family Medicine, 52(9), 665–667. https://doi.org/10.22454/FamMed.2020.708034
Bouchand, F., Leplay, C., Guimaraes, R., Fontenay, S., Fellous, L., Dinh, A., Deconinck, L., Sénard, O., Matt, M., Michelon, H., Perronne, C., Salomon, J., Villart, M., Izedaren, F., Pottier, S., Barbot, F., Orlikowski, D., Vaugier, I., & Davido, B. (2021). Impact of a medication reconciliation care bundle at hospital discharge on continuity of care: A randomised controlled trial. International Journal of Clinical Practice, 75(8). https://doi.org/10.1111/ijcp.14282
Brasil. Ministério da Saúde. (2013). Portaria no 3.390, de 30 de Dezembro de 2013. Diário Oficial Da União [Internet], 1–10. https://bvsms.saude.gov.br/bvs/saudelegis/gm/2013/prt3390_30_12_2013.html
Chiewchantanakit, D., Meakchai, A., Pituchaturont, N., Dilokthornsakul, P., & Dhippayom, T. (2020). The effectiveness of medication reconciliation to prevent medication error: A systematic review and meta-analysis. Research in Social and Administrative Pharmacy, 16(7), 886–894. https://doi.org/10.1016/j.sapharm.2019.10.004
Choi, S., & Babiak, J. (2018). Evaluation of pharmacist-initiated discharge medication reconciliation and patient counseling procedures. Consultant Pharmacist, 33(4), 222–226. https://doi.org/10.4140/TCP.n.2018.222
Cossette, B., Ricard, G., Poirier, R., Gosselin, S., Langlois, M. F., Breton, M., Sirois, C., Rodrigue, C., Lessard-Beaudoin, M., Teasdale, J., Piché, B., Khalilipalandi, S., Trottier, L., & Mallet, L. (2021). Pharmacist-led transitions of care for older adults at risk of drug-related problems: A feasibility study. Research in Social and Administrative Pharmacy, 17(7), 1276–1281. https://doi.org/10.1016/j.sapharm.2020.09.013
Duedahl, T. H., Hansen, W. B., Kjeldsen, L. J., & Graabæk, T. (2018). Pharmacist-led interventions improve quality of medicine-related healthcare service at hospital discharge. European Journal of Hospital Pharmacy, 25(e1), E40–E45. https://doi.org/10.1136/ejhpharm-2016-001166
Ferreira, V. de F., Martins, W., & Andrade, J. (2022). Communication and guidance in the transition of home care in post-discharge patients. Research, Society and Development, 11(8), e55611831341. https://doi.org/10.33448/rsd-v11i8.31341
Fosnight, S., King, P., Ewald, J., Feucht, J., Lamtman, A., Kropp, D., Dittmer, A., Sampson, J., & Shah, M. (2020). Effects of pharmacy interventions at transitions of care on patient outcomes. American Journal of Health-System Pharmacy, 77(12), 943–949. https://doi.org/10.1093/ajhp/zxaa081
George, D., Supramaniam, N. D., Abd Hamid, S. Q., Hassali, M. A., Lim, W. Y., & Hss, A. S. (2019). Effectiveness of a pharmacist-led quality improvement program to reduce medication errors during hospital discharge. Pharmacy Practice, 17(3). https://doi.org/10.18549/PharmPract.2019.3.1501
Ibarra Mira, M. L., Caro-Teller, J. M., Rodríguez Quesada, P. P., Garcia-Muñoz, C., Añino Alba, A., & Ferrari Piquero, J. M. (2021). Impact of a Pharmaceutical Care Program at Discharge on Patients at High Risk of Readmission According to the Hospital Score. Journal of Pharmacy Technology, 37(6), 310–315. https://doi.org/10.1177/87551225211047607
Imfeld-Isenegger, T. L., Studer, H., Ceppi, M. G., Rosen, C., Bodmer, M., Beeler, P. E., Boeni, F., Häring, A. P., Hersberger, K. E., & Lampert, M. L. (2021). Detection and resolution of drug-related problems at hospital discharge focusing on information availability – a retrospective analysis. Zeitschrift Fur Evidenz, Fortbildung Und Qualitat Im Gesundheitswesen, 166, 18–26. https://doi.org/10.1016/j.zefq.2021.08.004
Lázaro Cebas, A., Caro Teller, J. M., García Muñoz, C., González Gómez, C., Ferrari Piquero, J. M., Lumbreras Bermejo, C., Romero Garrido, J. A., & Benedí González, J. (2022). Intervention by a clinical pharmacist carried out at discharge of elderly patients admitted to the internal medicine department: influence on readmissions and costs. BMC Health Services Research, 22(1). https://doi.org/10.1186/s12913-022-07582-6
Lee, R., Malfair, S., Schneider, J., Sidhu, S., Lang, C., Bredenkamp, N., Liang, S. F. S., Hou, A., & Virani, A. (2019). Evaluation of Pharmacist Intervention on Discharge Medication Reconciliation. The Canadian journal of hospital pharmacy, 72(2), 111–118.
March, K. L., Peters, M. J., Finch, C. K., Roberts, L. A., McLean, K. M., Covert, A. M., & Twilla, J. D. (2022). Pharmacist Transition-of-Care Services Improve Patient Satisfaction and Decrease Hospital Readmissions. Journal of Pharmacy Practice, 35(1), 86–93. https://doi.org/10.1177/0897190020958264
Mendes, K. S.; Silveira, R. C.; C. S.; Galvão, C. M. (2019). Uso De Gerenciador De Referências Bibliográficas Na Seleção Dos Estudos Primários Em Revisão Integrativa. Texto e Contexto: Enfermagem, 146(4), 511–517.
Nguyen, V., Sarik, D. A., Dejos, M. C., & Hilmas, E. (2018). Development of an interprofessional pharmacist-nurse navigation pediatric discharge program. Journal of Pediatric Pharmacology and Therapeutics, 23(4), 320–328. https://doi.org/10.5863/1551-6776-23.4.320
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., & Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Systematic Reviews, 10(1). https://doi.org/10.1186/s13643-021-01626-4
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Hillary dos Santos Amorim; Eliane Szücs dos Santos
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.