Medication reconciliation and seamless care led by clinical pharmacists in Slovenia: a national reimbursed program ensuring safe and effective transition of care.

Abstract

Background: Medication errors frequently happen during patients' transitions between different healthcare settings. Medication reconciliation, provided by various healthcare specialists, could help reduce these errors. However, clinical pharmacists do not lead this service nationally in most countries.

Aim: This paper describes the development, implementation, and national evaluation of medication reconciliation in Slovenia as part of seamless care.

Setting: All hospitals and community pharmacies in Slovenia.

Development: The initial step involved the successful development of legislation in Slovenia. This process, termed 'seamless care,' was defined as a pharmaceutical service and five different steps of this process were developed: medication reconciliation upon admission (including the best possible medication history), during discharge, personal medication cards, and medication dispensing. A standard operational procedure was established in 2023 to guide these practices.

Implementation: A critical milestone in the implementation process was establishing a successful reimbursement scheme in 2023. Hospitals and community pharmacies implemented this service following successful reimbursement. Pharmacy managers and heads of hospital pharmacy departments were responsible for overseeing its implementation in hospitals and community pharmacies. The Health Insurance Institute of Slovenia is measuring the implementation.

Evaluation: Trials were conducted in various Slovenian hospitals to evaluate this service's effectiveness, appropriateness, and adoption before its full implementation (reduced medication-related problems were observed). The Health Insurance Institute of Slovenia is currently evaluating the sustainability of the service and providing feedback to the providers.

Conclusion: Slovenia is the first country in this part of Europe to fully reimburse and implement medication reconciliation as a pharmaceutical service. This practice holds promise for exporting to other countries.