Proposal for a pharmaceutical orientation at hospital discharge based on an overview and professional experiences

Abstract

The pharmaceutical orientation in hospital discharge can contribute to patient health management, especially in the rational use of medications. It seeks to improve treatment adherence, reduce adverse reactions, and decrease hospital readmissions and mortality. This study aims to describe the pharmaceutical discharge orientation process, identifying the phases and materials used in hospital discharge. It is characterized as an overview, including systematic reviews studies on hospital discharge orientation and action by pharmacists. And exclusion criteria adopted: studies that specifically addressed a health problem or specific population or did not describe the discharge process. We did a workshop with authors with professional experience in the theme to describe the orientation. It was observed that for discharge orientation, it is necessary to contextualize the patient in their home environment both before and after hospitalization. The discharge service includes several activities, such as medication reconciliation, hospital discharge advice (health education), and pharmacotherapy review. Medication lists and their scheduling, discharge summaries, and reconciliation forms were adopted as strategies for the pharmaceutical discharge service. It was possible to observe that many authors refer to the need for post-discharge follow-up by adopting strategies such as phone calls, home visits, text messages, and e-mails exchange. Based on the results, it was possible to systematize a proposal for a  pharmaceutical process for hospital discharge orientation and conclude that communication between health professionals and patients or caregivers during or after hospital discharge can promote better results.