Medication Transitions of Care in Trauma and Acute Care Surgery Patients.

Abstract

Background: Although the benefits of improved transitions of care regarding medications are widely known, implementation is variable among inpatient settings and populations and requires an interprofessional effort. This article reviews the body of published research on challenges with medication history taking and reconciliation for inpatients requiring treatment of traumatic injuries or surgical intervention.

Review of evidence: A comprehensive search of PubMed and MEDLINE databases from inception to February 2021, the reference lists of qualifying articles, and PubMed's "similar article" suggestions were used to identify publications based on the following key terms: patient transfer, transitional care, medication reconciliation, general surgery, and surgical procedures. Publications relevant to trauma and surgical patient populations were selected. Only 11 articles met the full criteria.

Implementation: The general challenges of accurate medication reconciliation at admission are also often barriers in the trauma and general surgery population. Discerning trends in the literature and evidence-based practice may be helpful.

Evaluation: The publications revealed many barriers to medication reconciliation at admission, in the intensive care unit, and at intensive care unit and hospital discharge.

Sustainability: Practices that can overcome these challenges include persistence in obtaining accurate information, paying close attention to changes in dosage or dosage forms and resumption of home medications at intensive care unit discharge, and having a follow-up plan for prescribing and deprescribing at hospital discharge.

Conclusion: Clear guidelines are needed for performing medication assessments at the bedside, including the role of each health care professional who conducts them and how the process is coordinated.