Community pharmacist-led post-discharge medication management improved patient outcomes across 42 studies, though limited by inconsistent handover, high workloads, and non-integrated systems.
Does community pharmacist-led post-discharge medication management improve patient outcomes during transitions of care?
Community pharmacists play a critical role in mitigating medication-related risks during transitions of care, but their integration is limited by systemic barriers like poor digital interoperability and lack of reimbursement.
Abstract Background Transitions of care (TOC) between hospital and community settings are high‐risk periods for medication‐related problems (MRPs), often caused by inadequate information transfer between healthcare settings. Community pharmacists are well positioned to support continuity of care; however, they are frequently excluded from the transitional care team. Understanding information transfer and the role of community pharmacists in TOC is essential to improving patient outcomes during this high‐risk period. Aim The aim of this scoping review was to comprehensively map and synthesise the existing evidence on medication information transfer during TOC and the roles of community pharmacists. Design This review followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for scoping reviews (PRISMA‐ScR) guidelines and applied the Arksey and O'Malley framework in accordance with the Joanna Briggs Institute Population, Concept, Context model. Cochrane Library, Embase, PubMed, CINAHL and Scopus were searched for peer‐reviewed articles that addressed medicine information transfer and the role of community pharmacists during TOC for patients discharged from hospital to community settings, published between 2013 and 2025. Data were charted using a pre‐defined Excel template and findings were narratively synthesised and thematically grouped. Results A total of 42 studies were included in the analysis. Studies demonstrated that community pharmacist‐led post‐discharge medication management improved patient outcomes. However, effective clinical handover to community pharmacy was often inconsistent or delayed. Implementation of community pharmacist services was limited by high workloads, a lack of reimbursement and non‐integrated digital health systems. Conclusion This review highlighted that poor communication and incomplete information transfer during TOC contribute substantially to poor patient outcomes, and that community pharmacists play a critical role in mitigating these risks through medication reconciliation, medication reviews and patient counselling. Strengthening digital interoperability, standardising discharge documentation and integrating community pharmacists within multidisciplinary frameworks are essential to optimise post‐discharge care.
Bailey et al. (Mon,) conducted a review in Transitions of care and medication-related problems (n=42). Community pharmacist-led post-discharge medication management was evaluated on Medication information transfer and patient outcomes during transitions of care. Community pharmacist-led post-discharge medication management improved patient outcomes across 42 studies, though limited by inconsistent handover, high workloads, and non-integrated systems.