title: A systematic review of the role of community pharmacies in improving the transition from secondary to primary care.
abstract: OBJECTIVE
  We set out to determine the potential contribution of community pharmacists to improve the transfer of care of patients from secondary to primary care settings.
  
  
  METHODS
  We systematically reviewed the literature on interventions that involved community pharmacy post-discharge. We considered all relevant studies, including both randomized and non-randomized controlled trials, irrespective of patient population. Our primary outcome was any impact on patient and medication outcomes, while the secondary outcome was to identify intervention characteristics that influenced all reported outcomes.
  
  
  RESULTS
  We retrieved 14 studies that met our inclusion criteria. There were four studies reporting outcomes relating to the identification and rectification of medication errors that were significantly improved with community pharmacy involvement. Other patient outcomes such as medication adherence and clinical control were not unanimously positively or negatively influenced via the inclusion of community pharmacy in a transfer of care post-discharge intervention. Some inconsistencies in implementation and process evaluation of interventions were found across the reviewed studies. This limited the accuracy with which true impact could be considered.
  
  
  CONCLUSIONS
  There is evidence that interventions including a community pharmacist can improve drug related problems after discharge. However, impact on other outcomes is not consistent. Further studies are required which include process evaluations to describe fully the context of the intervention so as to determine better any influencing factors. Also applying more stringent controls and closer adherence to protocols in both intervention and control groups would allow clearer correlations to be made between the intervention and the outcomes.
authors.affiliation: School of Medicine, Pharmacy and Health, Durham University, Queen's Campus, Stockton, TS17 6BH.
authors.forename: Hamde
authors.initials: H
authors.lastname: Nazar
authors.affiliation: School of Pharmacy and Biomedical Sciences, University of Portsmouth, White Swan Road, Portsmouth, PO1 2DT.
authors.forename: Zachariah
authors.initials: Z
authors.lastname: Nazar
authors.affiliation: School of Pharmacy and Biomedical Sciences, University of Portsmouth, White Swan Road, Portsmouth, PO1 2DT, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Portlock
authors.affiliation: School of Medicine, Pharmacy and Health, Durham University, Queen's Campus, Stockton, TS17 6BH.
authors.forename: Adam
authors.initials: A
authors.lastname: Todd
authors.affiliation: School of Medicine, Pharmacy and Health, Durham University, Queen's Campus, Stockton, TS17 6BH.
authors.forename: Sarah P
authors.initials: SP
authors.lastname: Slight
mesh_terms: D003157:Community Pharmacy Services; D003266:Continuity of Patient Care; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control*; D010595:Pharmacists; D011320:Primary Health Care; D024382:Professional Role; D063127:Secondary Health Care
keywords: community pharmacist; community pharmacy; community pharmacy intervention; continuity of care; hospital care; transfer of care