Interventions to improve the continuity of medication management upon discharge of patients from hospital to residential aged care facilities

Aim: The aim of this study was to undertake a systematic review of the literature and evaluate interventions used to improve continuity of medication management upon transition of care from an acute hospital setting to a residential aged care facility (RACF). Data sources: Embase, PubMed, The Cochrane Database of Systematic Reviews, Google Scholar, Informit Health Collection, grey literature and reference mining of included studies (from inception to March 2018). Study selection: Interventions aimed at improving the continuity of medication management upon discharge of patients from hospital to an RACF or similar facility were included. Interventions were defined as a communication tool or a service initiated by any healthcare professional. Studies were excluded if they were not available in English, had certain study designs (i.e. qualitative, observational and systematic review) and if no abstract and full-text article could be obtained. Results: Seven studies met the inclusion criteria. All interventions involved a multidisciplinary approach to discharge facilitation including the provision of discharge medication information. Six studies included pharmacist-led medication reconciliation. Two studies used an RACF-specific medication chart. Although positive findings were shown for most interventions, critical analysis of the studies included identified many limitations. Conclusion: Interventions involving a multidisciplinary team, pharmacist-led medication reconciliation and the provision of accurate discharge information have been identified as improving continuity of medication management during transitions of care from hospital to RACF. Importantly, this systematic review has identified an ongoing need for development of a comprehensive intervention that addresses all barriers to optimal continuity of medications encountered during this high-risk transition