<p>Pharmacists and medication reconciliation: a review of recent literature</p>

Abstract

Background : Adverse drug event (ADE) errors are common and costly in health care systems across the world. Medication reconciliation is a means to decrease these medication-related injuries and increase quality of care. Research has shown that medication reconciliation accuracy and efficiency improved when pharmacists are directly involved in the process. Objective : We review studies examining how pharmacists impact the medication reconciliation process and we discuss pharmacists’ future roles during the medication reconciliation process and then barriers pharmacy staff may face during this critical process. Methods : A comprehensive literature search from MEDLINE and manual searching of bibliographies was performed for the time period January 2012 through November 2018. Conclusion : Although the issue of rising costs and injury due to medication errors in our health care system are not solvable via medication reconciliation alone, it is the first and perhaps most critical piece of the medication management puzzle. As such, numerous organizations have called for pharmacists to expand their roles in the medication reconciliation process due to their expertise in medication management.

The impact of community–pharmacist-led medication reconciliation process: Pharmacist–patient-centered medication reconciliation

“…Patients and their healthcare providers’ are in need to access a correct list of prescribed and nonprescribed drugs, supplements, and/or herbal formularies when required for safe and effective clinical care. [ 1 2 3 4 5 6 7 ] Currently, Healthcare Information Systems are not providing a proper access to the patients’ medications lists. [ 3 4 5 6 7 ]…”

“…Medication reconciliation is a well-positioned process that guides the healthcare providers to have a comprehensive view on patients’ medications lists to minimize the medication discrepancies and devastating outcomes. [ 4 8 ] It is a robust process designed to create the most accurate list of medications that the patient can receive by making clinical decisions based on reviewing the current prescribed medications against the medications list that were prescribed for each patient. [ 1 4 ]…”

“…[ 4 8 ] It is a robust process designed to create the most accurate list of medications that the patient can receive by making clinical decisions based on reviewing the current prescribed medications against the medications list that were prescribed for each patient. [ 1 4 ]…”

“…The most importantly is to deliver the new medication list to the patients and their healthcare providers’. [ 4 ] Even though the pharmacists are the right persons to offer patient-centered medication care that involves reconciling medications, they are not fully involved especially in community pharmacies. [ 4 8 9 10 ] The process has faced a lot of difficulties particularly when the patient transfers between the healthcare settings.…”

The prescribing cascade- spotting and aborting it

“…A complete medication history along with proper medication reconciliation can prevent physicians from adding medicines unnecessarily in the first place. Medication reconciliation being the process of creating the utmost detailed list of all the medications a patient is taking-including drug name (generics), dosage, dosage form, frequency and route; and comparing the list against physician's admission, transfer and/or discharge orders, so as to provide correct medicines to the patient at all transition points within the hospital 9 . The "Brown Bag Review" of medicines by the pharmacists is considered a valuable tool of medication reconciliation 10 .…”