International Journal of Clinical Pharmacy

, Volume 39, Issue 5, pp 980–984 | Cite as

Optimising patient safety using pharmaceutical intervention in domiciliary hospitalization

  • Ana Mafalda BritoEmail author
  • Ana Margarida Simões
  • Armando Alcobia
  • Filipa Alves da Costa


Introduction The domiciliary hospitalization unit (DHU) is an innovative model of care provision, where hospital care is transferred to the patients’ home. However, this shift adds a care transition layer to the process, which may increase the probability of medication errors to occur. Method A pharmacist has been integrated into the DHU team to improve medication use. We developed an observational study documenting his intervention for 6 months. Information about the patient’s drug therapy before admission, during hospitalization and after hospital discharge were gathered, enabling comparison of possible discrepancies that may happen during care transitions. The pharmacist evaluated the appropriateness, necessity, effectiveness, and safety of medication and intervened when deemed appropriate. Conclusions Data suggests that a pharmacist involved in the DHU may have a positive impact on medication use. Medication review and reconciliation are examples of pharmaceutical interventions that may lead to increased effectiveness and patient safety.


Continuity of patient care Home care services Hospital-based Medication reconciliation Patient safety Pharmaceutical care Portugal 



The authors wish to acknowledge the domiciliary hospitalization unit team for cooperating in data collection.


All costs were supported by the researchers and the organisations involved.

Conflicts of interest

The authors declare they have no financial relationships that might lead to a conflict of interest.


  1. 1.
    Life expectancy at birth: overall and by gender (base: three years from 2001 onwards) Portugal. INE, PORDATA. (2017). Accessed 04 April 2017.
  2. 2.
    Resident population: overall and by age group—Portugal. INE, PORDATA. (2017). Accessed 03 April 2017.
  3. 3.
    Christensen M, Lundh A. Medication review in hospitalised patients to reduce morbidity and mortality. Cochrane Database Syst Rev. 2013;1:2.Google Scholar
  4. 4.
    NHS: appointments, admissions and emergencies—Mainland Portugal. INE, PORDATA. (2016). Accessed 21 March 2017.
  5. 5.
    NHS: beds in health establishments per 100 thousand inhabitants - Mainland Portugal—Portugal. INE, PORDATA. (2017). Accessed 31 March 2017.
  6. 6.
    Berchet, C. Emergency care services: trends, drivers and interventions to manage the demand. OECD Health Working Papers, No 83. Paris: OECD Publishing; 2015. doi: 10.1787/5jrts344crns-en.
  7. 7.
    Length of hospital stay (indicator). OECD. doi:  10.1787/8dda6b7a-en (2016 ). Accessed 15 August 2016.
  8. 8.
    Hospital beds (indicator). OECD. doi:  10.1787/0191328e-en (2016). Accessed 15 August 2016.
  9. 9.
    Krska J, Cromarty JA, Arris F, Jamieson D, Hansford D, Duffus PR, Downie G, Seymour DG. Pharmacist-led medication review in patients over 65: a randomized, controlled trial in primary care. Age Ageing. 2001;30(3):205–11.CrossRefPubMedGoogle Scholar
  10. 10.
    Fernandes O, Shojania KG. Medication reconciliation in the hospital: what, why, where, when, who and how. Healthc Q. 2012;15(special):42–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Kwan JL, Lo L, Sampson M, Shojania KG. Medication reconciliation during transitions of care as a patient safety strategy: a systematic review. Ann Int Med. 2013;158(5 Part 2):397–403.CrossRefPubMedGoogle Scholar
  12. 12.
    Brito AM, Pires AM, Alcobia A, Costa FA. From hospital to domiciliary hospitalization: a pharmacist intervention. In: Abstracts PCNE working conference 2017. Bled, Slovenia. 1–3 February 2017. Int J Clin Pharm. 2017;39(3):601–626.Google Scholar
  13. 13.
    Mason S, Mountain G, Turner J, Arain M, Weber EJ. Innovations to reduce demand and crowding in emergency care; a review study. Scand J Trauma Resusc Emerg Med. 2014;22(1):55.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Aitken M, Valkova S. Avoidable costs in US healthcare: the $200 billion opportunity from using medicines more responsibly. IMS Inst Healthc Inform. 2013;1:20–1.Google Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Centro de Investigação Interdisciplinar Egas Moniz (CiiEM)Instituto Superior de Ciências da Saúde Egas Moniz (ISCSEM)CaparicaPortugal
  2. 2.Hospital Garcia de Orta (HGO)AlmadaPortugal
  3. 3.Portuguese Pharmaceutical Society (PPS)LisbonPortugal

Personalised recommendations