Medication reconciliation is a prerequisite for obtaining a valid medication review

Area of Science:

• Clinical Pharmacy
• Patient Safety
• Medication Management

Background:

• Medication errors and drug-related problems (DRPs) pose significant risks to patient safety.
• Effective methods for identifying and mitigating these errors are essential in clinical practice.

Purpose of the Study:

• To compare the effectiveness of medication reconciliation and medication review in identifying discrepancies and DRPs.
• To assess the number, type, and severity of errors detected by each method.

Main Methods:

• A retrospective study was conducted in a cardiology department.
• Medication reconciliation involved comparing patient records, electronic medication systems (EMS), and discharge summaries (DS).
• Medication review was based solely on the EMS, with errors assessed using a four-point scale for clinical importance.

Main Results:

• Medication reconciliation identified 198 discrepancies (2.6/patient), with omissions and record-EMS discrepancies being most common. 15% were potentially serious or fatal.
• Medication review identified 129 DRPs (1.7/patient), with sub-therapeutic dosage and inappropriate regimens being most frequent. 35% were potentially serious or fatal.
• While reconciliation found more errors overall, review identified a higher proportion of serious errors.

Conclusions:

• Medication reconciliation and medication review detect different types of errors.
• Medication review identified a higher percentage of serious drug-related problems.
• Both methods are complementary and should be used concurrently to enhance patient safety and medication management.