Transfer of care – a randomised control trial investigating the effect of sending the details of patients’ discharge medication to their community pharmacist on discharge from hospital

Objective: There is substantial evidence demonstrating that transferring patients between care providers is a high-risk area for medicines management. This study aimed to investigate the effect of sending patients’ hospital discharge letters to their nominated community pharmacists on the number of discrepancies between the patient’s general practitioner (GP) records and the discharge letter and between the patient’s self-described medication regime and the discharge letter. Methods: In a randomised, controlled trial, 33 participants in two groups, control and intervention, had their discharge letter sent to either their GP only or their GP and nominated community pharmacy after hospital discharge. At least 3 weeks after hospital discharge, the participant’s current GP’s medication record and their self-described medication regime was obtained. Discrepancies between their GP medication record and their discharge letter and between the participant’s self-described medication regime and their discharge letter were counted. The number of discrepancies (relative to the number of drugs pre- scribed) in the intervention group was compared with the control group for each of the above two categories, using the chi-squared test to determine the statistical significance of any differences between the two groups. Results: The intervention group had statistically fewer discrepancies than the control group for both data sets: GP records compared with the discharge letters (P < 0.0005); participants’ self-described medication regimes compared with the discharge letters (P < 0.00005). Conclusions: Sending a copy of patients’ discharge letters to their community pharmacists could be beneficial in reducing post-discharge prescribing discrepancies and improving patient understanding of the changes made to their medicines.