Background Medication discrepancies can lead to adverse drug events and patient harm. Medication reconciliation is a process intended to reduce medication discrepancies. We developed a Secure Messaging for Medication Reconciliation Tool (SMMRT), integrated into a web-based patient portal, to identify and reconcile medication discrepancies during transitions from hospital to home. Objective We aimed to characterize patients’ perceptions of the ease of use and effectiveness of SMMRT. Methods We recruited 20 participants for semistructured interviews from a sample of patients who had participated in a randomized controlled trial of SMMRT. Interview transcripts were transcribed and then qualitatively analyzed to identify emergent themes. Results Although most patients found SMMRT easy to view at home, many patients struggled to return SMMRT through secure messaging to clinicians due to technology-related barriers. Patients who did use SMMRT indicated that it was time-saving and liked that they could review it at their own pace and in the comfort of their own home. Patients reported SMMRT was effective at clarifying issues related to medication directions or dosages and that SMMRT helped remove medications erroneously listed as active in the patient’s electronic health record. Conclusions Patients viewed SMMRT utilization as a positive experience and endorsed future use of the tool. Veterans reported SMMRT is an effective tool to aid patients with medication reconciliation. Adoption of SMMRT into regular clinical practice could reduce medication discrepancies while increasing accessibility for patients to help manage their medications. Trial Registration ClinicalTrials.gov NCT02482025; https://clinicaltrials.gov/ct2/show/NCT02482025
Medication discrepancies, defined as unintended differences between medication lists, 1 occur in up to 60% of patients' electronic health records (EHRs). [2][3][4] They are associated with adverse drug events and increased healthcare utilization [5][6][7][8] ; thus, the Joint Commission recommends medication reconciliation to resolve discrepancies between patient-reported medications and those documented within the record. 9Medication reconciliation tools to identify and correct discrepancies can provide patient safety and cost-related benefits. 7 Discrepancy types within classification systems differ, but common types include Commission (i.e., medication present in EHR but patient not taking), Omission (i.e., medication absent from EHR), and Drugdose (i.e., dose missing or incorrect). 10
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