Electronic tools to support medication reconciliation: a systematic review

Marien, Sophie; Krug, Bruno; Spinewine, Anne

doi:10.1093/jamia/ocw068

Cited by 50 publications

(47 citation statements)

References 31 publications

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“…The challenge for MedRec lies in the availability, reliability, and completeness of the data used . For this purpose, information technology could be used to support and improve the data collected for MedRec …”

Section: Introductionmentioning

confidence: 99%

“…5 For this purpose, information technology could be used to support and improve the data collected for MedRec. 7 In France, the Electronic Pharmaceutical Record (ePR) was created at the request of the health authority 8 that the ePR was the only source of information available for 25% of the cases. 9 The ePR could also be useful for other populations, especially to meet the challenge of MedRec for elderly patients on multiple drugs, particular features predictive of the occurrence of unintentional discrepancies.…”

Section: Introductionmentioning

confidence: 99%

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The Electronic Pharmaceutical Record: A new method for medication reconciliation

Jurado

Calmels

Lobinet

et al. 2018

Evaluation Clinical Practice

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Electronic Pharmaceutical Record: A new method for medication reconciliation

Jurado

Calmels

Lobinet

et al. 2018

Evaluation Clinical Practice

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“…According to recent reports[17] [18], IT is also an important tool for reducing unintentional discrepancies. However, rigorous studies to evaluate the impact of electronic MedRec (eMedRec) are lacking [17,19].…”

Section: Introductionmentioning

confidence: 99%

“…The SEAMPAT project chose to actively engage patients and to support HCPs -both in primary and secondary care -through specific eMedRec applications [18,19]. The SEAMPAT platform consists of two applications interconnected with the ReHN: one for patients (the "patient app") and one for HCPs (MedRec App).…”

Section: Introductionmentioning

confidence: 99%

“…Both were developed according to recommendations by health IT experts [28][29][30][31][32]. Functional and non-functional 3 requirements for the low-fidelity prototypes were defined on the basis of needs analysis and literature review [19,33]. These then evolved to medium-and high-fidelity prototypes using an iterative user-centered design with three main iterations.…”

Section: Introductionmentioning

confidence: 99%

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A web application to involve patients in the medication reconciliation process: a user-centered usability and usefulness study (Preprint)

Marien¹,

Legrand²,

Ramdoyal³

et al. 2017

Preprint

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Background: Medication discrepancies consist of unexplained differences between medication lists at different transition points of care; they are a threat to patient safety. These discrepancies can be solved through medication reconciliation (MedRec), a complex and time-consuming process. Several approaches to optimizing MedRec have been encouraged, including the development of information technology (IT) tools and patient engagement. The SEAMPAT project aims to develop a MedRec IT platform based on two applications (one for the patient, the "patient app", the other for healthcare professionals), which were developed using a three-iteration user-centered design. The patient app presents the patient with a medication list compiled from different medication resources. Objective: To evaluate the usability and usefulness of the third iteration of the patient app, from the perspective of different categories of users, with the aims of making recommendations for wider use and informing further research. Methods: We performed a four-month user-centered observational study. After a kick-off session, patients, identified through purposive sampling, were invited to use the patient app at home, to update their medication lists whenever required. Quantitative and qualitative data were collected at different time points to evaluate three dimensions of usability (efficiency, satisfaction, and effectiveness), as well as usefulness. Participants completed two questionnaires on satisfaction and usefulness (including the system usability scale, SUS) at the kick-off and the end of the study. Effectiveness was assessed by measuring the completeness and correctness (i.e. medication discrepancies) of the final medication list generated by the patient application. Qualitative data were collected from observations at different time points and from semi-structured interviews at the end of the study. Results: Forty-eight patients agreed to participate and 42 completed the study, of whom 32 connected at least once to the application at home. Sixty-nine percent of patients considered the patient app to be acceptable (SUS Score ≥ 70) and perceived usefulness was high. The medication list was complete for a quarter of the patients and there was a median of two discrepancies per patient. The main causes were technology-related. The qualitative data enabled the identification of several barriers and, thus, of approaches to optimizing usability and usefulness. These relate to both functional (e.g. access, on-screen display, additional functionalities) and non-functional aspects (e.g. patient awareness, concordance between patient and physician) of the application. For future adoption of the tool, it will be important to address these issues. Conclusions: Our findings highlight the importance and value of user-centered usability testing of a patient application implemented in "real-world" conditions. We believe our study also underlines the need to take patients' points of view into consideration. To achieve adoption and sustained use by...

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Effect of an Electronic Medication Reconciliation Intervention on Adverse Drug Events

et al. 2019

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Key PointsQuestionDoes an electronic medication reconciliation tool reduce the occurrence of adverse drug events and other adverse outcomes in the 30 days after discharge?FindingsIn this cluster randomized trial that included 3491 patients discharged from 2 medical units and 2 surgical units of 1 academic hospital, electronic medication reconciliation reduced medication discrepancies but had no effect on adverse drug events (primary outcome), emergency department visits, or readmission in the 30 days after discharge.MeaningHospital accreditation requirements for medication reconciliation should be revised to focus on interventions that will reduce the risk of adverse events for patients with multiple changes to their community medication.

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Electronic tools to support medication reconciliation: a systematic review

Abstract: Successful implementation of electronic tools to support MedRec requires favorable context, properly designed tools, and attention to implementation features. Future research is needed to evaluate the effect of these tools on the quality and safety of healthcare.

Cited by 50 publications

References 31 publications

The Electronic Pharmaceutical Record: A new method for medication reconciliation

The Electronic Pharmaceutical Record: A new method for medication reconciliation

A web application to involve patients in the medication reconciliation process: a user-centered usability and usefulness study (Preprint)

Effect of an Electronic Medication Reconciliation Intervention on Adverse Drug Events

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