{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:29:01Z","timestamp":1787311741153,"version":"build-2736575974"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T00:00:00Z","timestamp":1714348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Transition of care when a patient moves between healthcare locations is a risk factor for medication errors and medicines-related preventable harm. The aims of this retrospective service evaluation were to understand, by classifying and quantifying, the nature of interventions made by community pharmacy when receiving a discharge medicines service referral from a secondary care hospital, with a focus on two groups of high-risk medicines supplied at discharge\u2014oral anticoagulants and weak opioids following hip or knee surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Records made on the PharmOutcomes\u2122 platform by community pharmacists in response to referral for the NHS England discharge medicines service were analysed and summarized. This analysis was exploratory and interpretative in nature and used a convenience sample of patients who had consented for the service over 12 months from May 2022 to April 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key findings<\/jats:title>\n                    <jats:p>During 12 months, 6811 referrals occurred, of which 71% were recorded as having different stages of the service completed on PharmOutcomes\u2122. Medicines reconciliation, first-prescription review, and consultation stages decreased as patients progressed through the service. Slightly greater rates of completion were observed for patients receiving oral anticoagulants and for codeine or dihydrocodeine following hip and knee surgery, although overall referrals were low for this latter cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Through this service, community pharmacists are well placed to support the safe and effective use of medicines including oral anticoagulants and weak opioids posthospital discharge and potentially reduce incidents of avoidable harm. The variations in recorded completion rates across the three stages of the service and the apparent greater finalization rates for the high-risk medicines studied require further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ijpp\/riae021","type":"journal-article","created":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T19:20:01Z","timestamp":1712863201000},"page":"274-279","source":"Crossref","is-referenced-by-count":3,"title":["Community pharmacy discharge medicines service activity as recorded in PharmOutcomes: a retrospective exploration and analysis"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6407-6272","authenticated-orcid":false,"given":"Michael","family":"Wilcock","sequence":"first","affiliation":[{"name":"Pharmacy Department, Royal Cornwall Hospitals NHS Trust , Cornwall, TR1 3LJ , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0903-2514","authenticated-orcid":false,"given":"Liam","family":"Bastian","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Royal Cornwall Hospitals NHS Trust , Cornwall, TR1 3LJ , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Jones","sequence":"additional","affiliation":[{"name":"NHS Cornwall and Isles of Scilly Integrated Care Board , Cornwall, PL31 2FR , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wasim","family":"Baqir","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Northumbria Healthcare NHS Foundation Trust , Tyne and Wear, NE29 8NH , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,4,29]]},"reference":[{"key":"2024070409013361200_CIT0001","author":"World Health 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contributory factors of medication safety incidents following hospital discharge using National Reporting and Learning System (NRLS) data from England and Wales: a multi-method study","volume-title":"Ther Adv Drug Saf","author":"Alqenae","year":"2023"},{"key":"2024070409013361200_CIT0016","author":"NHS England","year":"2023"},{"key":"2024070409013361200_CIT0017","first-page":"6","article-title":"Involving community pharmacy in communication about post-surgery opioid use: an observational study","volume":"5","author":"Wilcock","year":"2023","journal-title":"PM Healthcare J"},{"key":"2024070409013361200_CIT0018","author":"NHS England","year":"2023"},{"key":"2024070409013361200_CIT0019","article-title":"How we are using the discharge medicines service to help patients on high-risk medicines","volume-title":"Pharm J PJ","author":"Wilcock","year":"2021"},{"key":"2024070409013361200_CIT0020","first-page":"246","article-title":"TransitionRx: impact of community pharmacy postdischarge medication therapy management on hospital readmission rate","volume-title":"J Am Pharm Assoc (2003)","author":"Luder","year":"2015"},{"key":"2024070409013361200_CIT0021","first-page":"202","article-title":"Impact of a community pharmacy transitions-of-care program on 30-day readmission","volume-title":"J Am Pharm Assoc (2003)","author":"Shaver","year":"2019"},{"key":"2024070409013361200_CIT0022","first-page":"2040","article-title":"Development of an innovative partnership between a health-system department of pharmacy and external community pharmacies","volume-title":"Am J Health Syst Pharm","author":"Vest","year":"2022"},{"key":"2024070409013361200_CIT0023","first-page":"33","article-title":"Discharge communications from hospital to community pharmacy - reasons for rejection","volume":"35","author":"Wilcock","year":"2018","journal-title":"J Pharm Man"},{"key":"2024070409013361200_CIT0024","first-page":"e0283836","article-title":"Qualitative investigation of barriers to providing an electronic hospital to community pharmacy referral service for discharged patients","volume-title":"PLoS One","author":"Khayyat","year":"2023"},{"key":"2024070409013361200_CIT0025","first-page":"i42","article-title":"Evaluating the utilisation of a service designed to enhance care with medicines following acute hospital discharge: a retrospective study","volume-title":"Int J Pharm Prac","author":"Alqenae","year":"2021"},{"key":"2024070409013361200_CIT0026","author":"NHS Business Services Authority","year":"2023"},{"key":"2024070409013361200_CIT0027","first-page":"203","article-title":"Evaluation of patients\u2019 knowledge about oral anticoagulant medicines and use of alert cards by community pharmacists","volume-title":"Int J Clin Pharm","author":"Jani","year":"2021"},{"key":"2024070409013361200_CIT0028","first-page":"2352","article-title":"Role of pharmacists in optimising opioid therapy for chronic non-malignant pain: a systematic review","volume-title":"Res Social Adm Pharm","author":"Iqbal","year":"2022"},{"key":"2024070409013361200_CIT0029","first-page":"180","article-title":"Roles, barriers, and behavioral determinants related to community pharmacists\u2019 involvement in optimizing opioid therapy for chronic pain: a qualitative study","volume-title":"Int J Clin Pharm","author":"Alenezi","year":"2022"}],"container-title":["International Journal of Pharmacy 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