What errors can be identified by Pharmacy-led medicines reconciliation? A prospective study

Area of Science:

• Pharmacy Practice
• Patient Safety
• Clinical Pharmacy

Background:

• Medication errors are a significant concern in healthcare, impacting patient outcomes.
• Accurate medication reconciliation (MR) is crucial for preventing adverse drug events upon hospital admission.

Purpose of the Study:

• To determine the types and frequency of discrepancies found by pharmacy staff during medication reconciliation.
• To identify common medication errors during the admission process.

Main Methods:

• Prospective data collection over one week involving 161 patients.
• Pharmacy staff systematically identified and recorded prescription errors during medication reconciliation.

Main Results:

• 48% of patients (62 out of 161) had at least one discrepancy identified.
• The most frequent discrepancy observed was the omission of one or more prescribed medications.
• Discrepancies were identified in patients taking one or more medications prior to admission.

Conclusions:

• Pharmacy staff play a vital role in uncovering unintentional prescribing discrepancies.
• Clear documentation of intentional medication changes by physicians is essential to improve medication safety.
• Findings underscore the importance of robust medication reconciliation processes in hospitals.