Using novel Canadian resources to improve medication reconciliation at discharge: study protocol for a randomized...

Area of Science:

• Health Services Research
• Patient Safety
• Pharmacovigilance

Background:

• Adverse drug events (ADEs) contribute to 7% of hospital admissions, with over 58% being preventable.
• Medication reconciliation is crucial for reducing ADEs during care transitions.
• Electronically enabled discharge reconciliation offers an innovative solution to improve medication safety.

Purpose of the Study:

• To evaluate the effectiveness of an electronically enabled discharge reconciliation process.
• To reduce adverse drug events, emergency room visits, and hospital readmissions post-discharge.
• To improve medication reconciliation adherence and communication between hospital and community care providers.

Main Methods:

• A prospective trial involving 3,714 participants across 26 medical and surgical units in Quebec.
• Cluster randomization to compare electronic discharge reconciliation and communication versus usual care.
• Primary outcome: ADEs at 30 days post-discharge; Secondary outcomes: ER visits and readmissions.

Main Results:

• The study aims to detect a 5% reduction in adverse drug events.
• Analysis will use logistic regression within a generalized estimating equation framework to account for clustering.
• The intervention is expected to improve medication reconciliation accuracy and communication.

Conclusions:

• Electronically enabled discharge reconciliation may reduce post-discharge ADEs, ER visits, and readmissions.
• The intervention is anticipated to enhance medication reconciliation adherence and accuracy.
• Findings could inform policy, hospital accreditation, and software development for medication safety.