Transitions of care: integrating pharmacists to prevent harm worldwide

A patient is discharged from hospital with six new prescriptions and a limited understanding of the changes made to their treatment. Within a week, the patient is readmitted to the emergency department, not because of the underlying illness, but as a direct consequence of preventable medication-related harm. This scenario is replicated worldwide, across high, middle and low-income countries. Transitions of care (TOC) remain among the most vulnerable points in healthcare, generating avoidable harm, unnecessary costs, and suffering for patients and families.1–3 These stories are not rare exceptions. They occur every day in every health system, and they often remain invisible until they culminate in an emergency visit or hospital admission. Behind each case lies a caregiver suddenly overwhelmed, a patient whose independence is compromised, and a health system that absorbs unnecessary costs. The challenge is universal, and yet our collective response remains fragmented and inconsistent.4 Studies consistently report that up to half of discharged patients experience a medication discrepancy, one in five suffers an adverse drug event, and around 16% of readmissions are drug related, nearly half of which are preventable. These figures are not trivial. They translate into millions of avoidable harms each year.5 The economic impact is staggering. In England, medication-related harm after discharge costs an estimated £396 million annually. In the United States, preventable readmissions cost Medicare about $17 billion annually.6 In lower-resource settings, where health budgets are already stretched thin, the consequences are even more profound: every preventable readmission displaces resources from other pressing priorities.7 WHO estimated that unsafe medication practices and errors account for 42 million adverse events annually, many of which occur during transitions. In response, WHO’s Medication Without Harm challenge has rightly prioritised safer transitions as a global imperative.8 But numbers alone do not capture the full burden. What does … Correspondence to Dr Esteban Zavaleta-Monestel; ezavaleta{at}clinicabiblica.com