Impact of patient-held medication records (PHMRs) on medication management across the continuum of health care: a systematic review and narrative synthesis

Objectives To investigate the impact of patient-held medication records (PHMRs) on identifying and/or resolving medication discrepancies and other drug-related problems (DRPs) before, during or after care transition.

Design A systematic review and narrative synthesis.

Data sources Medline, Embase, PubMed, Cochrane via Ovid and CINAHL were searched from 1990 to 2025.

Eligibility Any study design investigating the impact of PHMRs in isolation or in combination with other interventions on medication discrepancies and other DRPs was included.

Data extraction and synthesis Quality of studies was assessed using the Mixed Methods Appraisal Tool. A narrative synthesis was undertaken. One reviewer screened the titles and abstracts, assessed full texts and extracted data from all papers with three additional reviewers collectively reviewing 10% at each stage.

Results A total of 31 studies were included: 13 reported data related to the impact of PHMRs on medication discrepancies, 10 on other DRPs and eight on both. 12 studies explored use of PHMRs integrated into routine clinical flows, with 10 showing that they contributed to the detection and resolution of discrepancies. Seven studies explored use of PHMRs enabling patients to independently complete reconciliation at home (eg, via patient portals). Five of these showed favourable findings in detecting and resolving discrepancies. The remaining two compared their use against standard medication reconciliation: one showed their non-inferiority, while the other favoured the standard process but noted similarities between them. 18 studies reported on other DRPs where PHMRs contributed to detecting and improving problems such as non-adherence (n=7), adverse drug events (ADEs) (n=4), therapeutic duplications or drug-interactions (n=3) and indication without medications (n=2). Two studies evaluating the rate of ADE (per patient) did not find significant findings.

Conclusion PHMRs can engage patients in their medication safety and contribute to improving medication management. Further large-scale studies are needed to better understand their effectiveness as well as their unintended consequences.

PROSPERO registration number

(CRD42022309343) - An amendment was made to update the search end date.