What type of study is this?

This is a Case Report study (also classified as: Quasi-Experimental, Systematic Review).

February 19, 2026

Bridging the Gap: Systematic Review of Strategies to Facilitate Post-Discharge Continuity of In-Hospital Medication Changes in Older Adults

KJKate J. R. JohnstoneThe University of Sydney SHSarah N. HilmerRoyal North Shore Hospital SLSarita LoThe University of Sydney

Key Points

To summarize strategies for ensuring continuity of in-hospital medication changes in older adults post-discharge and assess their impacts.
Conducted a systematic review of literature from MEDLINE and EMBASE (1946–2024).
Identified 49 studies meeting inclusion criteria, including various study types like quasi-experimental and randomized controlled trials.
Analyzed strategies such as discharge medication lists, counselling, and reconciliation across studies.
68.4% of studies reported significant improvements in continuity-related outcomes post-strategy.
61.9% of studies measuring medication discrepancies found significant reductions after strategies were implemented.
Quality of life improved in multiple studies, while health service utilisation showed no significant changes.

Abstract

In-hospital medication changes are a key component of healthcare of older adults. It is important to employ strategies to ensure continuity of changes post-discharge. This systematic review aimed to summarise (i) strategies that have been investigated to facilitate post-discharge continuity of in-hospital medication changes in older adults and (ii) their impact on continuity of medication changes and clinical, health service utilisation and patient-reported outcomes. MEDLINE and EMBASE databases were searched (1946–20/03/2024) to identify strategies that facilitate post-discharge continuity of hospital medication changes and assess their impact on continuity, health service utilisation, and clinical and patient-reported outcomes post-discharge in older adults (mean/median age ≥60 years). After screening 800 articles, 49 met inclusion criteria, including 25 quasi-experimental studies, 14 randomised controlled trials, four cohort studies, four observational studies, one case series, and one retrospective case note review and audit. Strategies commonly involved providing discharge medication lists to patients and/or their general practitioners (36/49 studies, 73.5%), discharge counselling (28/49, 57.1%) and medication reconciliation (28/49, 57.1%). Most studies used multi-component strategies (39/49, 79.6%) by multi-disciplinary teams (28/49, 57.1%). Twenty-six of the 36 studies (68.4%) assessing the impact of strategies on continuity reported significant improvements in continuity-related outcomes. Thirteen out of the 21 studies (61.9%) that measured medication discrepancies (most common measure of continuity) reported significant reductions following strategy implementation. One out of 11 studies (9.1%) reported a significant improvement in clinical outcomes, while none of the 13 studies found significant improvements in health service utilisation outcomes. Two of three studies investigating patient-reported quality of life reported significant improvements. Strategies focus on communicating medication changes to patients, general practitioners and community pharmacists by multi-disciplinary hospital clinicians. There is evidence of a positive impact of multi-component strategies delivered by a multi-disciplinary team on continuity of medication changes and quality of life post-discharge. Future analyses investigating strategy complexity and cost effectiveness may inform their translation into practice.

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