Communicating medication changes to community pharmacy post-discharge: the good, the bad, and the improvements

Int J Clin Pharm. 2013 Oct;35(5):813-20. doi: 10.1007/s11096-013-9813-9. Epub 2013 Jun 29.


Background: Communication between hospital and community pharmacists when a patient is discharged from hospital can improve the accuracy of medication reconciliation, thus preventing unintentional changes and ensuring continuity of supply. It allows problems to be resolved before a patient requires a further supply of medication post-discharge. Despite evidence demonstrating the benefits of sharing information, community pharmacists' willingness to receive information and advances in information technology (particularly electronic discharge medication summaries), there is little published evidence to indicate whether communication has improved over the last 15 years. This study aimed to explore community pharmacists' experience of information sharing by and with their local hospital and GP practices.

Objectives: (1) To establish the extent to which community pharmacies currently receive discharge medication information, and for which patients.(2)To determine community pharmacy staff opinion on where and how current communication practice could be improved.

Setting: Community Pharmacies in one Primary Care Organisation (PCO) in England.

Method: Semi-structured interviews conducted during visits to community pharmacies.

Main outcome measure: Reported receipt of discharge medication information from hospitals and general practices.

Results: A total of 14 community pharmacies participated. Current provision of information to community pharmacies from hospitals regarding medication changes at discharge was reported to be inconsistent and lacking in quality. Where information was received it was predominantly for patients who receive their medicines in monitored dosage systems (MDS) rather than for the general population of patients. Some examples of "notable practice" were reported.

Conclusion: Community pharmacists received post-discharge information rarely and mainly for patients where the hospital perceived the patient's medication issues as "complex". Practice was inconsistent overall. These findings suggest that the potential of community pharmacists to improve patient safety after discharge from hospital is not being utilised.

MeSH terms

  • Attitude of Health Personnel
  • Communication Barriers
  • Community Pharmacy Services*
  • Drug Monitoring
  • Electronic Health Records*
  • General Practitioners
  • Humans
  • Information Dissemination / methods*
  • Interdisciplinary Communication*
  • Medication Errors / prevention & control*
  • Medication Reconciliation / methods*
  • Patient Discharge
  • Patient Discharge Summaries*
  • Personnel, Hospital
  • Pharmacists
  • Primary Health Care
  • Quality Improvement
  • State Medicine
  • United Kingdom
  • Workforce