International Journal of Clinical Pharmacy

, Volume 35, Issue 6, pp 1040–1052 | Cite as

Initiatives promoting seamless care in medication management: an international review of the grey literature

  • Coraline Claeys
  • Veerle Foulon
  • Sabrina de Winter
  • Anne SpinewineEmail author
Review Article


Background Patients’ transition between hospital and community is a high-risk period for the occurrence of medication-related problems. Aim of the review The objective was to review initiatives, implemented at national and regional levels in seven selected countries, aiming at improving continuity in medication management upon admission and hospital discharge. Method We performed a structured search of grey literature, mainly through relevant websites (scientific, professional and governmental organizations). Regional or national initiatives were selected. For each initiative data on the characteristics, impact, success factors and barriers were extracted. National experts were asked to validate the initiatives identified and the data extracted. Results Most initiatives have been implemented since the early 2000 and are still ongoing. The principal actions include: development and implementation of guidelines for healthcare professionals, national information campaigns, education of healthcare professionals and development of information technologies to share data across settings of care. Positive results have been partially reported in terms of intake into practice or process measures. Critical success factors identified included: leadership and commitment to convey national and local forces, tailoring to local settings, development of a regulatory framework and information technology support. Barriers identified included: lack of human and financial resources, questions relative to responsibility and accountability, lack of training and lack of agreement on privacy issues. Conclusion Although not all initiatives are applicable as such to a particular healthcare setting, most of them convey very interesting data that should be used when drawing recommendations and implementing approaches to optimize continuity of care.


Continuity of care International experience Medication therapy management Medication errors Quality improvement 



The authors thank all experts who participated in the validation process: Simon Bell, Thimothy Chen, Glena Ellit, Rebekah Moles, Margaret Colquhoun, Louise Mallet, Tina Eriksson, Henrik Schroll, Simon Schytte-Hansen, Saskia Vercaeren, Catherine Picton, Benoît Allenet, J. F. Schüsler, Nicolette van Horssen, Fatma Karapinar and Maureen Layden. We also thank Christine Bond and Dominique Paulus for their critical reading of the report.


This study was supported by the Belgian Health Care Knowledge Center, a state-funded research institution. One representative reviewed and commented the literature search, data analysis and interpretation of the results. The present paper represents an update of this work. The funding source had no influence on the preparation of the manuscript or the decision to submit the manuscript for publication.

Conflicts of interest



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Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2013

Authors and Affiliations

  • Coraline Claeys
    • 1
  • Veerle Foulon
    • 2
  • Sabrina de Winter
    • 3
  • Anne Spinewine
    • 4
    • 5
    • 6
    Email author
  1. 1.Laboratory of Pharmaceutical Chemistry, Faculty of PharmacyUniversité Libre de BruxellesBrusselsBelgium
  2. 2.Research Centre for Pharmaceutical Care and Pharmaco-economicsKatholieke Universiteit LeuvenLeuvenBelgium
  3. 3.Pharmacy Hospital Department, University Hospital of LeuvenKatholieke Universiteit LeuvenLeuvenBelgium
  4. 4.Louvain Drug Research Institute, CHU Mont-Godinne DinantUniversité catholique de LouvainBrusselsBelgium
  5. 5.Clinical Pharmacy Research Group, Louvain Drug Research InstituteUniversité Catholique de LouvainBrusselsBelgium
  6. 6.Pharmacy Department, CHU Mont-GodinneUniversité Catholique de LouvainYvoirBelgium

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