Hospital-based medication reconciliation practices: a systematic review.

Area of Science:

• Health Services Research
• Patient Safety
• Pharmacology

Background:

• Medication discrepancies frequently occur during care transitions, increasing the risk of patient harm.
• Medication reconciliation is a critical strategy to mitigate these risks.
• Evidence on effective medication reconciliation interventions in hospital settings is synthesized.

Purpose of the Study:

• To summarize existing evidence on medication reconciliation interventions within hospitals.
• To identify the most effective practices for inpatient medication reconciliation.

Main Methods:

• A systematic literature search of MEDLINE and bibliographies was conducted (1966–February 2012).
• Twenty-six controlled studies evaluating medication reconciliation interventions were selected.
• Data extraction focused on study design, intervention components, and outcomes; studies were quality-rated.

Main Results:

• Interventions included pharmacist-related (15 studies), information technology (6 studies), and other approaches (5 studies).
• Medication reconciliation consistently reduced discrepancies, potential adverse drug events, and adverse drug events.
• Successful interventions featured intensive pharmacy staff involvement and targeted high-risk patient populations.

Conclusions:

• High-quality comparative studies on inpatient medication reconciliation are limited.
• Current evidence supports interventions utilizing pharmacy staff and focusing on high-risk patients.
• Further research is needed to determine optimal inpatient medication reconciliation strategies.