<p>Hospital-Wide Medication Reconciliation Program: Error Identification, Cost-Effectiveness, and Detecting High-Risk Individuals on Admission</p>

Abstract

Background: Medication reconciliation (MR) on admission has potential to reduce negative patient outcomes. The objectives of this prospective observational study were to 1) measure the impact a hospital-wide MR program has on home medication error identification at hospital admission, 2) demonstrate cost-effectiveness of this program, and 3) identify risk factors placing individual patients at higher risk for medication discrepancies. Methods: Technicians obtained medication histories on adult patients admitted to the hospital that managed their own medications. Frequency and type of medication errors were recorded. Cost avoidance estimations were determined based on expected adverse drug event rates. Logistic regression analysis was used to test for associations between medication errors and patient characteristics. Results were considered significant when p-value was less than 0.05. Results: The study included 817 patients. Technicians recorded a mean of 6.1 medication discrepancies per patient (SD ± 0.4) and took 28.5 minutes (SD ± 1.2 minutes) to complete a medication history. Omission, commission, and dosing/frequency errors occurred in 82%, 59%, and 50% of medication histories, respectively. We estimated cost avoidance of $210.33 per patient with this program. Female gender, age, and high alert/risk medication use were linked to an increase in the likelihood of occurrence of a medication discrepancy. Conclusion: This study validated the ability of a pharmacy technician to identify errors, demonstrated economic cost-effectiveness, provided new data on time to obtain a BPMH, and further identified factors that contribute to the occurrence of medication discrepancies. Potentially harmful medication discrepancies were identified frequently on admission. With further research, it may be possible to identify those at highest risk for home medication discrepancies upon admission.

Medication reconciliation on discharge in a tertiary care Riyadh Hospital: An observational study

“…It is described by the Agency for Healthcare Research and Quality (AHRQ) as the method or technique used by health care providers to compile a full and accurate medication list for a patient’s prescription and home medications [ 1 ]. Medication reconciliation in clinical practice is considered an essential step to ensure patient safety and to avoid discrepancies or inconsistencies in patient’s medications at the time of admission [ 2 ] or transition from one unit to another or at the time of discharge [ 3 ]. Elderly patients with a severe condition, are at high risk for medication discrepancies due to the multiple re-admission, and change in drug generics [ 4 ].…”

Development and psychometric assessment of self-reported patient medication safety scale (SR-PMSS)

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Reducing Medication Errors: Rethinking Prescribing Drugs in Standardized Units over Quantities of Ingredients

“…Usually, monetary costs exceed $40 billion each year to treat these patients (7). A study conducted in the USA reported a mean of 6.1 medication discrepancies per patient and medication errors such as omission, commission, and dosing/frequency errors occurred in 82%, 59%, and 50% of medication histories, respectively (8). Even though medication errors are a primary concern in developed countries, their significance is undervalued in developing countries.…”