Hospital-Based Medication Reconciliation Practices: A Systematic Review

3 Jul 2012 | Medication Safety

In this study, published last month by the American Medical Association, the authors reviewed 26 medicine reconciliation studies with the aim of identifying the most efficient practices.

Fifteen of 26 studies reported pharmacist-related interventions, six evaluated IT interventions, and five studied other interventions. Studies consistently demonstrated a reduction in medication discrepancies (17 of 17 studies), potential adverse drug events (5 of 6 studies), and adverse drug events (2 of 2 studies) but showed an inconsistent reduction in post discharge health care improvement (improvement in 2 of 8 studies).

The authors concluded that medication reconciliation–related processes with a high degree of pharmacy staff involvement produced the best patient outcomes. They found that targeting patients considered at greatest risk of an adverse drug event, such as elderly patients, patients taking many medicines, and patients with many comorbidities, may be of highest benefit.  Several studies did combine these criteria to define an intervention high risk patient group but were inconclusive on which combinations provided greatest benefit. The evidence also suggests that taking an accurate medication history on admission and communicating with post discharge providers are important steps.

Higher-quality studies comparing different inpatient medication reconciliation practices are needed to determine the most effective approaches to inpatient medication reconciliation.

The full article can be accessed on the JAMA website.

A Medscape article on the report, including a link to invited commentary,  is available on their website. (Free registration is required to access the article.)

Last updated 25/07/2012