Medication discrepancies revealed by medication reconciliation and their potential short-term and long-term effects: a Norwegian multicentre study carried out on internal medicine wards

Nilsson, Niklas; Lea, Marianne; Lao, Yvonne Elisabeth; Wendelbo, Katherine; Gløersen, Gløer; Mowé, Morten; Blix, Hege Salvesen; Viktil, Kirsten K.

doi:10.1136/ejhpharm-2015-000686

Cited by 28 publications

(42 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Compared with two studies with similar profiles regarding approach, definitions and healthcare systems,8 10 discrepancies on admission were more frequent in the present study (4.1/patient vs 3.2/patient8 and 3.4/patient10). We attribute this difference to external factors.…”

Section: Discussioncontrasting

confidence: 60%

“…We attribute this difference to external factors. For example, our cohort had a high number of drugs (9.1 drugs after reconciliation vs 6.08 and 7.2)10 and frequent changes in medication. Both studies reported a positive correlation between the number of drugs on admission and the number of discrepancies observed.…”

Section: Discussionmentioning

confidence: 99%

“…According to the US Institute for Healthcare Improvement, a lack of accuracy in medication history is responsible for 50% of medication errors and for 20% of ADE in hospitals 8. In a recent Spanish study, 50% of medication histories on admission and 83% of discharge prescriptions were incomplete or imprecise 9.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Medication reconciliation in a Swiss hospital: methods, benefits and pitfalls

Nachar¹,

Lamy

Sadeghipour

et al. 2018

Eur J Hosp Pharm

View full text Add to dashboard Cite

ObjectivesTo assess the feasibility and main obstacles to the implementation of a medication reconciliation (MR) process in a Swiss hospital and to develop a standardised method which can be used in similar healthcare systems.MethodsFor this prospective, observational single-centre and single-ward study, a best possible medication history (BPMH) was established by a clinical pharmacist for 147 patients with heart failure based on two sources and a patient interview for each case. Identified discrepancies with medication histories established during emergency service were conveyed to the ward physician. At the end of each hospital stay, the planned discharge treatments were compared with the BPMHs to identify discrepancies and to propose modifications. After a final validation, the comparative treatment plans were distributed.ResultsMR was conducted for 120 (82%) patients and the mean time needed was 74 min/patient. At least one discrepancy was identified among 94% of the patients on admission, with 4.1 discrepancies found per patient (mainly omissions). At discharge, 83% of the patients had at least one discrepancy, with 2.3 discrepancies found per patient (mainly unintentional substitutions). The majority (86%) of pharmaceutical interventions to adjust the discharge prescriptions were accepted by the physician.ConclusionsA standardised method of MR which offers precise definitions of discrepancies and key tools for the process was developed. This method was applicable to most of our cohort and it effectively identified medication discrepancies. Two potential obstacles for its implementation are the time needed for MR and the questionable impact of pharmaceutical interventions on discrepancies.

show abstract

Section: Discussioncontrasting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Medication reconciliation in a Swiss hospital: methods, benefits and pitfalls

Nachar¹,

Lamy

Sadeghipour

et al. 2018

Eur J Hosp Pharm

View full text Add to dashboard Cite

show abstract

“…Our finding that the participants used in average 4.2 regular drugs is in line with other studies reporting on persons with chronic conditions using in average 3-5 regular drugs. [19][20][21] Only a third of the participants in our cohort used oral spasmolytic drugs regularly, even though nearly 80% of them reported at least some level of spasticity. The explanation could be that mild spasticity can have a positive impact on functionality, or the fact that the most common oral spasmolytic drugs come with undesirable side effects as sedation and dizziness.…”

Section: Discussionmentioning

confidence: 88%

Use of medicines, adherence and attitudes to medicines among persons with chronic spinal cord injury

Høgholen

Storhaug²,

Kvernrød³

et al. 2017

Spinal Cord

View full text Add to dashboard Cite

The persons with SCI included in this study used in average the same number of regular drugs compared to persons with other chronic conditions. Regardless of high overall adherence, the participants were more concerned about their medicines compared to other patient groups. Further studies are required for understanding adherence and attitudes toward medicines in this population, especially to help the persons with chronic SCI feel safe about their drug regimen.

show abstract

“…1 Up to 27% of all hospital prescribing errors can be attributed to medication histories being incomplete at the time of admission, with 27% to 83% of patients having at least 1 medication history error at the time of admission with the potential to adversely affect care over the long term. [6][7][8] Accreditation Canada does not identify which patients would be considered at high risk and which would be most at risk for adverse drug events. Therefore, Canadian emergency departments must develop a risk assessment approach to identify these groups.…”

Section: 3mentioning

confidence: 99%

Reliability of Best Possible Medication Histories Completed by Non-admitted Patients in the Emergency Department

Macdonald

Manuel

Brennan

et al. 2017

CJHP

View full text Add to dashboard Cite

Background: Accreditation standards have outlined the need for staff in emergency departments to initiate the medication reconciliation process for patients who are at risk of adverse drug events. The authors hypothesized that a guided form could be used by non-admitted patients in the emergency department to assist with completion of a best possible medication history (BPMH). Objective: To determine the percentage of patients in the non-acute care area of the emergency department who could complete a guided BPMH form with no clinically significant discrepancies (defined as no major discrepancies and no more than 1 moderate discrepancy). Methods: This prospective exploratory study was conducted over 4 weeks in February and March 2016. Data were collected using the self-administered BPMH form, patient interviews, and a data collection form. After completion of the guided BPMH form, patients were randomly selected for interview by a pharmacy team member to ensure their self-completed BPMH forms were complete and accurate. Eligible patients were those with non-acute needs who had undergone triage to the waiting room. Patients who were already admitted and those with immediate triage to the acute care or trauma area of the emergency department were excluded. Results: Of the 160 patients who were interviewed, 146 (91.3%) completed the form with no more than 1 moderate discrepancy (but some number of minor discrepancies). There were no discrepancies in 31 (19.4%) of the BPMH forms, and 101 (63.1%) of the forms had only minor discrepancies. Conclusions: Most of the patients interviewed by the pharmacy team were able to complete the BPMH form with no clinically significant discrepancies. The self-administered BPMH form would be a useful tool to initiate medication reconciliation in the emergency department for this patient population, but used on its own, it would not be a reliable source of BPMH information, given the relatively low number of patients who completed the form with no discrepancies.

show abstract

Medication discrepancies revealed by medication reconciliation and their potential short-term and long-term effects: a Norwegian multicentre study carried out on internal medicine wards

Cited by 28 publications

References 15 publications

Medication reconciliation in a Swiss hospital: methods, benefits and pitfalls

Medication reconciliation in a Swiss hospital: methods, benefits and pitfalls

Use of medicines, adherence and attitudes to medicines among persons with chronic spinal cord injury

Reliability of Best Possible Medication Histories Completed by Non-admitted Patients in the Emergency Department

Contact Info

Product

Resources

About