Medication Review During Transitions of Care During Hospital Discharge: A Review of Evidence on Effectiveness in Preventing Medication Errors

Background: Medication errors remain a major global challenge, particularly during transitions of care such as hospital discharge. Medication review during transitions of care has been recognized as a structured intervention to prevent discrepancies, ensure accuracy in prescriptions, and safeguard continuity of care. Methods: This review synthesizes global and regional evidence on the effectiveness of reconciliation processes, highlighting their role in reducing medication discrepancies, adverse drug events (ADEs), and hospital readmissions. Results: It further explores the contribution of healthcare professionals, patient engagement, systemic barriers, technological innovations, and the specific challenges faced in low- and middle-income countries (LMICs) such as India. Findings consistently demonstrate that structured, pharmacist-led, and multidisciplinary approaches to reconciliation significantly improve patient outcomes, but implementation gaps and resource limitations remain pressing challenges. Conclusion: The review concludes that institutionalization of reconciliation as a core patient safety strategy, supported by technology and policy frameworks, is essential to reduce preventable harm at discharge.