The impact of medication reconciliation and review in patients using oral chemotherapy

Abstract

Background and aim Verifying and reviewing a patients medication list can detect and reduce drug related problems (DRPs). However little is known about its effects in patients using oral chemotherapy. The aim of this study was to evaluate the impact of these interventions and the adapted Medication Appropriateness Index (aMAI) as a tool to carry out a medication review. Methods A case-control study was carried out. The hospital pharmacist performed a medication reconciliation and medication review, using the aMAI tool, in 54 patients starting oral chemotherapy. Discrepancies, DRP's and associated pharmaceutical interventions were reported via the electronic patient record (EPR). After one month, the acceptance rate was measured and the aMAI score recalculated. Kappa statistics were used to test intra- and interrater reliability. Results The medication list in the EPR was incomplete in 74,1% of patients with an average of 2.4 errors per patient. After medication review, the aMAI score decreased significantly from 7.2 to 5.4 (SD = 4,7; p <0.001), indicating an improvement in the appropriateness of the drugs patients were taking. Acceptance rates were 41,4% and 53,2% for advices resulting from medication reconciliation and medication review respectively. Kappa values of 0.90 and 0.70 respectively indicate good intra- and interrater reliability. Discussion and conclusion The study shows that medication reconciliation can identify and address discrepancies. Furthermore, medication review seems to ensure that drug treatment better meets patient needs. The aMAI was a reliable tool. Future research will have to determine the clinical relevance of these interventions.

From the Randomized AMBORA Trial to Clinical Practice: Comparison of Medication Errors in Oral Antitumor Therapy

“…Another cause for lower frequencies of medication errors in the randomized AMBORA trial compared to clinical routine might be that physicians' referral to or patients' participation in the AMBORA trial within a study environment might have caused a partial avoidance of medication errors, indicating an even higher actual potential for errors and patient harm (see 10 ) in clinical practice. In line with our findings, a recent analysis found a similarly high overall number of 2.4 medication errors per patient treated with OAT in clinical routine 23 . The distribution of important error characteristics within the complete medication was comparable in our primary analysis ( Figure ).…”

“…In line with our findings, a recent analysis found a similarly high overall number of 2.4 medication errors per patient treated with OAT in clinical routine. 23 The distribution of important error characteristics within the complete medication was comparable in our primary analysis (Figure 2). Interestingly, the overall percentage of drug-drug/drug-food interactions in the AMBORA Center was slightly smaller compared to the RCT (24.0% vs. 29.8%, Figure 2).…”

Introduction of Unit-Dose Care in the 1,125 Bed Teaching Hospital: Practical Experience and Time Saving on Wards

“…10 This results in additional costs for health care systems. [11][12][13] Previous studies have already highlighted the importance of the role of a CP for this purpose. 7,[14][15][16] Including a CP in evaluating prescriptions significantly reduces prescription errors and drug-related problems, thus increasing patient safety.…”

Pharmacy Safety and Occupational Health: Crisis and Disaster Management

“…[1][2][3][4][5] It provides essential medicines and supplies for chronic and emergency conditions, [6] preventing drugrelated mortality and mobility and voiding the unnecessary cost burden of healthcare services. [7][8][9][10][11][12][13] Pharmacy services are highly demanded in crises and disasters such as natural disasters and public health emergencies. [14,15] During crises, various challenges might occur, such as medication supply chain disruption, the high load of patients, destruction of pharmacy infrastructure, and offside communication and information about medication availability.…”