Improving communication of medication changes using a pharmacist-prepared discharge medication management summary

International Journal of Clinical Pharmacy
April 2017, Volume 39, Issue 2, pp 394–402

Choon Ean Ooi, Olivia Rofe, Michelle Vienet, Rohan A. Elliott

Abstract

Background Discontinuity of care between hospital and primary care is often due to poor information transfer. Medication information in medical discharge summaries (DS) is often incomplete or incorrect. The effectiveness and feasibility of hospital pharmacists communicating medication information, including changes made in the hospital, is not clearly defined. Objective To explore the impact of a pharmacist-prepared Discharge Medication Management Summary (DMMS) on the accuracy of information about medication changes provided to patients’ general practitioners (GPs). Setting Two medical wards at a major metropolitan hospital in Australia. Method An intervention was developed in which ward pharmacists communicated medication change information to GPs using the DMMS.

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