A transition of care is defined as a patient moving from one level of care to another, such as from a hospital to home or long-term care setting.  During these transitions’ patients may be vulnerable and more likely to experience medication errors.  Reports indicate that 1 out of 5 patients transitioning from the hospital setting will experience an adverse event, with 66% of these events being medication related.

There are often changes to a medication regimen while hospitalized.  The process of deciding which medications to continue and which to stop may be challenging, especially if there is not sufficient communication.  Even with clear discharge instructions it may be difficult to reconcile pre-admission medication lists with new discharge medications.  A pharmacist is an excellent resource for transitions of care.  A pharmacist can perform a medication reconciliation, comparing medication lists, to avoid medication errors such as omissions, duplications, dosing errors, or drug interactions.

Studies have shown that having a pharmacist as part of transitions of care can reduce hospital readmission, improve patient outcomes, and reduce adverse drug reactions.  Consider contacting a pharmacist to assist you or a loved one during transitions of care.