Transition of Care from Hospital to Community Pharmacies: A Literature Review and a Strengths, Weaknesses, Opportunities and Threats (SWOT) Analysis

Abstract

Background: Improving the quality of care during the transition of care from hospital to home, with the associated cost savings, waste reduction and improvements in service efficiency, is under pressure at the governmental level from the National Health Service in the UK. In terms of pharmacies, there are important issues regarding medicine prescribing and dispensing, where the reliance is currently on the hospitals rather than community pharmacies to provide prescribed medicines. This leads to delayed discharges, exacerbates the gap between demand and capacity and places additional demands on primary care to provide repeat prescriptions. Objective: A systematic review of the literature was undertaken to explore the different models used in implementing a change in the service due the transfer of dispensing from hospitals to community pharmacies, with the related benefits and limitations. Methods: Electronic databases and citation screening were used to conduct this review. Included studies were appraised using the Scottish Intercollegiate Guideline Network checklists. Narrative analysis was used to produce the findings of this review, followed by a strengths, weaknesses, opportunities, and threats (SWOT) analysis. Key Findings: Most of the transition of care models were found to have beneficial effects for both service and patient outcomes, especially with regard to cost savings, reduced hospital readmission rates due to medication and the greater efficiency and productivity of the service. Conversely, there were a number of limitations associated with dispensing by community pharmacies, including incomplete/incorrect prescriptions, increasing the demands and time required of the community pharmacists to resolve prescription issues and, most importantly, delays in the dispensing process as a result of these issues. Conclusion: This review highlights the current issues concerning the transitional models for dispensing medicine to patients who have been discharged from hospital. Future research is needed to pilot the proposed change in service with greater applicability to the UK to improve both the patient and service outcomes. Key words: transition of care, dispensing, community pharmacy