Evaluation of Pharmacy-Led Post-Discharge Follow-Up on Transitional Care Management in a Tertiary Academic Hospital: An Observational Study

Introduction: The administration of multiple medications and complex drug regimens has increased medication-related problems (MRPs) and associated factors. MRPs can occur at any stage of the medication process and are common after hospital discharge. Understanding and managing these problems are crucial for promoting safe and effective medication use. Objective: This study aimed to evaluate the prevalence of MRPs among post-discharge patients with high medication risk in the academic tertiary care hospital of King Abdulaziz University (KAUH) in Jeddah, Saudi Arabia. Methods: A prospective cross-sectional study was conducted, and data were collected through phone calls to discharged patients using validated questions. MRPs were identified based on the classification of the Pharmaceutical Care Network Europe (PCNE), and data analysis was performed using descriptive statistics. Results: Out of 287 screened participants, 201 fulfilled the inclusion criteria. The prevalence of MRPs among high-medication-risk patients after hospital discharge was substantial, with 519 MRPs identified. The most common types of MRPs were the need for medication information, untreated symptoms or indications, and nonadherence. Conclusion: The most prevalent MRPs among patients in our hospital were the need for education and untreated symptoms or indications. Future studies should investigate MRPs in larger samples and explore interventions by pharmacists.