Decreasing Unintended Medication Discrepancies in Medication Reconciliation through Simple Yet Effective Interventions

Abstract

Background: Medication reconciliation is the process of comparing a patient's medication orders to all of the medications that the patient has been taking. Unfortunately, medication errors are common in our health system accounting for significant proportion of patient harm. The main objective of our study was to explore the effect of self-designed intervention in improving the accuracy of patient current medication list in the outpatient settings. Methods: The study designed entailed collection of data from October 2013 to March 2014. The data collected in October (The pre-intervention) was compared to the post-intervention data in March 2014. Following interventions were performed: Education of residents, nurses and patients, frequent reminders to the residents to perform medication reconciliation, sending notifications to the residents who failed to perform medication reconciliation, reminding the patients get all refills at the time of appointment and reminding the patients to bring pill bottles at each appointment. The pre-intervention data was compared with the post-intervention data for different types of medication errors. Normality of the variables was pre assessed. Non-parametric analysis using Fisher's exact test was performed for comparison of categorical variables. Conclusion: In conclusion, our intervention improved the accuracy of patient current medication list in the electronic records as accurate as possible. For clinics and hospitals, medication reconciliation can enhance delivery of high value cost conscious care to the patients by reducing medication errors.

A Prospective Observational Study of Medication Reconciliation at Admission, Transfer and Discharge to Reduce Medication Discrepancies in Inpatient

“…Therefore, medication reconciliation on hospital admission or at patient transition points is an important element to prevent and minimize the adverse drug events. 8 The Joint Commission has included reconciliation of medications across the continuum of care as a 2007 National Patient Safety Goal. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) patient safety goal implementation expectations states, ''the organization with the patient's involvement creates a complete list of the patient's current medications at admission/entry''.…”

Effectiveness of an educational intervention in improving the patient medication reconciliation in the emergency department

“…Most patients rely on the healthcare staff for their medication in hospital but after discharge, when they have to take on this responsibility themselves, many discrepancies occur 7 . The language barrier, the severity of illness, poor patient understanding of the medication and a need to monitor the regimen exaggerate the discrepancies in medication 8 . Medication reconciliation, including an ‘indication review’ for each prescription, is an important aspect of patient safety.…”

“…7 The language barrier, the severity of illness, poor patient understanding of the medication and a need to monitor the regimen exaggerate the discrepancies in medication. 8 Medication reconciliation, including an 'indication review' for each prescription, is an important aspect of patient safety. The decreasing frequency of pill bottle reviews, suboptimal patient education and poor communication between healthcare providers are the factors that threaten patient safety.…”

Impact des conciliations médicamenteuses d’entrée proactives en amont des consultations pré-anesthésiques

“…Tahir et al où la mise en place de CME a fait passer le nombre de dossiers sans erreurs médicamenteuses de 13 à 38(50). En 2018 dans un service de diabétologie, la conciliation proactive a été comparée à celle rétroactive(51).…”