Clinical Pharmacist Interventions in Preventing Medication-Related Hospital Readmissions

Abstract

Hospital readmissions are an important indicator of healthcare quality, continuity of care, and patient safety. Medication-related problems, including adverse drug reactions, medication discrepancies, inappropriate prescribing, non-adherence, and inadequate patient education, may contribute to preventable hospital readmissions. Clinical pharmacists are increasingly involved in medication reconciliation, comprehensive medication review, discharge counselling, and post-discharge follow-up to improve medication safety during transitions of care.
This manuscript presents a systematic-review framework informed by published systematic reviews, meta-analyses, and clinical studies concerning pharmacist-led medication management during hospital admission, discharge, and post-discharge care. A definitive systematic review should search PubMed/MEDLINE, Embase, the Cochrane Library, CINAHL, and other relevant databases using reproducible search strategies. Eligible studies should compare pharmacist-led interventions with usual care or another relevant comparator and report hospital readmissions, medication-related readmissions, emergency department visits, adverse drug events, or other patient-relevant outcomes. Study selection, risk-of-bias assessment, and evidence synthesis must be completed and documented before the manuscript is represented as a fully conducted systematic review.