The effectiveness of medication reconciliation to prevent medication error: A systematic review and meta-analysis

Chiewchantanakit, Daranee; Meakchai, Anupong; Pituchaturont, Natdanai; Dilokthornsakul, Piyameth; Dhippayom, Teerapon

doi:10.1016/j.sapharm.2019.10.004

Cited by 17 publications

(12 citation statements)

References 13 publications

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“…The results support that NTUH-IMM increases the detection and reporting of MEs significantly in hospitalized patients, consistent with prior studies investigating the effects of pharmacist intervention on MEs [ 16 , 17 ]. Moreover, the number of medications used by late-elderly patients decreased after the implementation of the NTUH-IMM model.…”

Section: Discussionsupporting

confidence: 90%

Impact of integrated medication management program on medication errors in a medical center: an interrupted time series study

Chen

Hunag

Sheng

et al. 2022

BMC Health Serv Res

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Background Medication errors (MEs) are harmful to patients during hospitalization, especially elderly patients. To reduce MEs, an integrated medication management (IMM) model was developed in a 2500-bed medical center, allowing a clinical pharmacist to participate in the daily ward round and perform medication reconciliation and medication reviews. This study aimed to evaluate the impact of the IMM model on MEs and medication utilization using a quasi-experimental design. Methods We conducted an interrupted time-series study using the aggregated data of monthly admissions from two wards of a medical center, where one ward served as the intervention and the other served as the external control. The pre- and post-intervention phases comprised of 40 and 12 monthly observational units, respectively. The primary outcome was the mean number of ME reports, which were further investigated for different ME types. The mean number of daily inpatient prescriptions, mean number of daily self-prepared medications, and median daily medication costs were measured. All outcomes were measured per admission episode. Segmented regression was used to evaluate the level and slope changes in the outcomes after IMM model implementation, and subgroup analyses were performed to examine the effects on different groups. Results After IMM model implementation, the mean number of ME reports increased (level change: 1.02, 95% confidence interval [CI]: 0.68 to 1.35, P < 0.001). The number of reports has shown a dramatic increase in omissions or medication discrepancies, inappropriate drug choices, and inappropriate routes or formulations. Furthermore, the mean number of daily inpatient prescriptions was reduced for patients aged ≥75 years (level change: −1.78, 95% CI: −3.06 to −0.50, P = 0.009). No significant level or slope change was observed in the control ward during the post-intervention phase. Conclusions The IMM model improved patient safety and optimized medication utilization by increasing the reporting of MEs and decreasing the number of medications used.

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Section: Discussionsupporting

confidence: 90%

Impact of integrated medication management program on medication errors in a medical center: an interrupted time series study

Chen

Hunag

Sheng

et al. 2022

BMC Health Serv Res

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“…O predomínio da omissão pode estar ligado à obtenção do histórico medicamentoso de forma incompleta e pouco precisa, em consequência, de uma anamnese mal conduzida. Em oposição, em outros estudos, os erros mais encontrados foram: prescrição incompleta 16 , dose, via ou horário diferente 12,18 e adição 11 . Complementando estas informações, Kawan et al 26 relataram que a descontinuação inadvertida de agentes hipocolesterolêmicos, terapia de reposição de hormônios tireoidianos, terapia para osteoporose e gastrite pode carregar um risco maior para eventos adversos e reinternação nos próximos 30 dias.…”

Section: Discussionunclassified

“…A conciliação de medicamentos também reduziu em 75% o risco do paciente a erros de medicação, comparado com aqueles que não receberam este serviço 11 . Estes dados sinalizam para a relevância da conciliação para melhorar o uso seguro e racional dos medicamentos.…”

Section: Introductionunclassified

Reconciliation of medications upon the admission of patients to the cardiology sector of a university hospital

Miranda¹,

Cavalcante²,

Pinheiro³

et al. 2020

Rev Bras Farm Hosp Serv Saude

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Introduction: The reconciliation of medications is an important process that impacts on patient safety during the level of care transition, a moment with high discrepancy rates that can lead to adverse reactions. Objective: To analyze the results of medication reconciliation in order to identify discrepancies between the medical prescription and the medications previously used by the patient. Method: A descriptive, cross-sectional study was conducted between May and November 2017 (until the second fortnight of the month), with patients admitted to the cardiology department of the University Hospital of Brasília. Data was collected through interviews with patients, relatives and/or caregivers, and through consultation of the medical records. The reconciliation of medications was performed daily, from Monday to Friday, within 48 hours of the patient’s admission to the unit, through a medication reconciliation form prepared by the author. Results: 90 patients were included in the study and a total of 297 discrepancies were found, 267 (90%) being intentional and 30 (10%), unintentional. Among the unintentional discrepancies, the most frequent was omission of medication in use by the patient (56%). Of the intentional discrepancies, the dosage modifications were more common in 45% of the cases. Conclusion: The reconciliation of medications was a crucial clinical service for the identification and resolution of unintentional discrepancies between previously used medications and hospital medical prescription.

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“…Medication errors are common in the hospital [ 7 ] setting and lead to increased morbidity, mortality, and economic costs. Most of the effects occur at hospital admission and/or on discharge, that is, in the transition of patients between different levels of care [ 8 , 9 , 10 ]. These errors are due to the total or partial ignorance of a patient’s current treatment, in which necessary outpatient medications are omitted, duplications occur, and incorrect doses are prescribed, etc.…”

Section: Introductionmentioning

confidence: 99%

Influence of the COVID-19 Pandemic on Medication Reconciliation in Frail Elderly People at Hospital Discharge: Perception of Healthcare Professionals

Rojas-Ocaña

García-Navarro

et al. 2022

IJERPH

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The current demographic panorama in Spain corresponds to an aging population; this situation is characterized by the need to care for an elderly population, which contains polymedicated and pluripathological individuals. Polymedication is a criterion of frailty in the elderly and a risk factor for mortality and morbidity due to the increased risk of drug interactions and medication errors. There are numerous studies that measure reconciliation at hospital discharge and at admission, and even the methodology of reconciliation, but we have not found many studies that measure reconciliation in the context of the COVID-19 pandemic from the point of view of health professionals regarding difficulties and the strategies carried out, which is essential to begin to glimpse solutions. Methods. This was a qualitative study based on 21 in-depth interviews and two discussion groups, conducted between January and April 2021 (13 nurses and 8 doctors, in rural and urban areas). The discourse was analyzed according to the Taylor–Bodgan model and processed using Atlas.ti software. Results. The areas altered by the health crisis were access to patients, their reconciliation of medication, and changes in the care modality, including the greater use of telephone communication, changes in work organization, and time dedicated to patient care and family work. Difficulties encountered during COVID-19: change in medication format, the specific characteristics of the patient and their pathologies, and difficulties arising from communication with the patient and their family. The strategies applied: the collaboration of home assistants and caregivers, emphasis on patient–health professional communication, and the use of Information and Communication Technologies (ICT). Conclusion. The discharge was interrupted by the health crisis caused by COVID-19, in terms of both the traditional access of patients and by the remote care modalities generated by telemedicine.

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The effectiveness of medication reconciliation to prevent medication error: A systematic review and meta-analysis

Cited by 17 publications

References 13 publications

Impact of integrated medication management program on medication errors in a medical center: an interrupted time series study

Impact of integrated medication management program on medication errors in a medical center: an interrupted time series study

Reconciliation of medications upon the admission of patients to the cardiology sector of a university hospital

Influence of the COVID-19 Pandemic on Medication Reconciliation in Frail Elderly People at Hospital Discharge: Perception of Healthcare Professionals

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