Table 2.
Characteristics of the Studies Selected for Data Analysis and Synthesis
| Authors, Year, Country | Aim | Method/Full-Text Appraisal Score | Sample and Setting | The Role of the Nurse in Medicines Management During Transitional Care | Main Finding |
|---|---|---|---|---|---|
| Vogelsmeier, 2014, USA45 | To explore the perceptions of leaders and staff nurses of nursing homes concerning the process of medication reconciliation, with a focus on recognizing the medication order discrepancies | Qualitative/17 out of 21 | 18 leaders, 13 registered nurses, and 28 licensed practical nurses in 8 mid-western nursing homes | Primary role in medication reconciliations and a main role in identifying discrepancies in the medication order | Nursing home physicians rely on nurses to know about medicines; active vs passive information seeking in medication history and diagnosis of discrepancies; making sense of medication orders to recognize discrepancies |
| Chan et al, 2015, Canada46 | To compare the completeness and accuracy of best possible medication histories and reconciliation performed by a pharmacy technician (pilot study) and by nurses and/or pharmacists (baseline) | Prospective cohort comparison/25 out of 34 | 84 patients up to 18 years admitted to and/or transferred between the cardiac critical care unit and cardiology unit of a paediatric tertiary care teaching hospital | Transfer of medication reconciliation through obtaining best possible medication histories | No differences between the nurse and/or pharmacist and pharmacy technician in terms of the completion of best possible medication histories or completion of reconciliation within 24h of admission; transfer reconciliation completeness was higher in the pharmacy technician than nurse and/or pharmacist |
| Manias et al, 2015, Australia48 | To explore how healthcare providers, patients, and their family members communicate about managing medicines across transitional care points | Qualitative/18 out of 21 | 10 patients, 10 family members, 27 nurses, 15 pharmacists and 11 physicians from two public hospitals | Clarifying medicines’ concerns and patients' clinical parameters with doctors; nurses situated in the nursing home organize medicines' changes with a phone call to a general practitioner in the hospital when a patient transfers to the nursing home; performing interpersonal communication with patients and interdisciplinary communication was crucial for medicines management | Major themes: contextual environment of care, competing responsibilities of care, awareness of responsibility for safety, and interprofessional communication |
| Lovelace et al, 2016, USA40 | To investigate the impact of the McGuire veterans administration medical centre transitional care program on veteran emergency department and hospital utilization and costs | Retrospective review of medical records/24 out of 34 | 346 veterans from the Richmond, VA Hunter Holmes McGuire VAMC as a 399-bed facility | An initial assessment including an extensive medication review, collaboration with the pharmacist to provide an accurate discharge medication chart, making medication adjustments and order medications' renewals | Veterans who received transitional care program services had a 67% reduction in hospital admissions and a 61% reduction in emergency department visits in the 90 days after participation in the program |
| Reidt et al, 2016, USA43 | To describe the interprofessional collaborative practice model and compare the outcomes of participants who received care based on the model and those individuals who received routine care from the geriatrician and nurse practitioner in transition from the skilled nursing facility to home | Experimental/24 out of 37 | 87 participants in the intervention group received care based on the model, and 189 individuals in the comparison group received routine care at a non-profit skilled nursing facility with 60 transitional care unit beds | Provision of consultation to the pharmacist when unexplained changes occurred in the effectiveness of and safety of all prescriptions, collaborating with the pharmacist to determine the discharge medication regimen, and recommending items to the pharmacist to address at follow-ups | There was no difference in hospitalizations 30 days after discharge from the skilled nursing facility; participants receiving the intervention according to the model had a lower risk of emergency department visits |
| Al-Hashar et al, 2017, Oman47 | To investigate beliefs, responsibilities and perceived roles of nurses, pharmacists and physicians about the medication reconciliation process | Survey/18 out of 32 | 143 physicians, 47 pharmacists and assistant pharmacists and 274 nurses from a university tertiary care hospital with 450 beds | Nurses had a joint role with physicians and pharmacists in medication reconciliation in transitional care | A lack of clearness of current practices of medication reconciliation and a lack of agreement about other providers' role in medication reconciliation between the three healthcare professions |
| Chhabra et al, 2019, USA39 | To compare time spent by nurses and pharmacists according to the location of a medication-focused interview | Prospective, unblinded, cohort observational/26 out of 34 | 72 patients were randomized based on the location of pharmacist to be interviewed in the emergency department or on the floor in a 435-bed community hospital | Collecting medication history and performing medication reconciliation with admitting physicians | Pharmacists and nurses spent a mean of 10 minutes less per patient in the emergency department than patients on the medical floor for collecting medication history. The discrepancy in the transcript was found by the rate of 1 in 4 medications |
| Otsuka et al, 2019, USA41 | To examine the effect of an interprofessional transition of care facility on 30-day hospital reutilization | Retrospective cohort/28 out of 34 | 660 patients were in the interprofessional post-acute care clinic as in the intervention group and the comparison group from two outpatient clinics within an academic medical centre. | Performing the follow-up phone call to the patient or caregiver to begin the process of medication reconciliation by determining if patients were capable to fill their new prescriptions | 30-day hospital readmission was lower in the intervention group, but for emergency department visits no difference between the groups was found |
| Tjia et al, 2019, USA44 | To identify nurses' viewpoints about their role in hospice family caregivers' medication management | Secondary qualitative analysis/15 out of 21 | 6 home hospice nurses, 3 inpatient hospice nurses, and 1 medical home nurse coordinator for primary care from three hospice agencies and their referring hospital systems | Performing medication review as the key component of medication support and deprescribing process, providing education to increase medication knowledge to family caregivers, simplifying medication regimens as support to patient and family caregivers | Education, skill-building, support and counselling for family caregivers; need to an intervention to standardize patient-cantered medication review |
| Prusaczyk et al, 2020, USA42 | To discover the transitional care measures provided to older adults with and without dementia | Mixed methods/5 out of 6 | 9 healthcare providers in the qualitative phase and reviewing 126 patients with dementia and 84 without dementia from an urban, large academic medical centre with 9000 employees | Primary provision of education about medications, medication safety and being highly involved in medication reconciliation and medication review | Healthcare providers at the hospital had distinguished roles in the provision of transitional care to patients with different roles for patients with and without dementia |