1. Int J Clin Pharm. 2013 Sep 11. [Epub ahead of print]

Initiatives promoting seamless care in medication management: an international
review of the grey literature.

Claeys C, Foulon V, de Winter S, Spinewine A.

Laboratory of Pharmaceutical Chemistry, Faculty of Pharmacy, Université Libre de 
Bruxelles, Brussels, Belgium.

Background Patients' transition between hospital and community is a high-risk
period for the occurrence of medication-related problems. Aim of the review The
objective was to review initiatives, implemented at national and regional levels 
in seven selected countries, aiming at improving continuity in medication
management upon admission and hospital discharge. Method We performed a
structured search of grey literature, mainly through relevant websites
(scientific, professional and governmental organizations). Regional or national
initiatives were selected. For each initiative data on the characteristics,
impact, success factors and barriers were extracted. National experts were asked 
to validate the initiatives identified and the data extracted. Results Most
initiatives have been implemented since the early 2000 and are still ongoing. The
principal actions include: development and implementation of guidelines for
healthcare professionals, national information campaigns, education of healthcare
professionals and development of information technologies to share data across
settings of care. Positive results have been partially reported in terms of
intake into practice or process measures. Critical success factors identified
included: leadership and commitment to convey national and local forces,
tailoring to local settings, development of a regulatory framework and
information technology support. Barriers identified included: lack of human and
financial resources, questions relative to responsibility and accountability,
lack of training and lack of agreement on privacy issues. Conclusion Although not
all initiatives are applicable as such to a particular healthcare setting, most
of them convey very interesting data that should be used when drawing
recommendations and implementing approaches to optimize continuity of care.

PMID: 24022724  [PubMed - as supplied by publisher]