Should nurses or clinical pharmacists perform medication reconciliation? A randomized controlled trial

Area of Science:

• Pharmacology and Pharmacy Practice
• Patient Safety and Quality Improvement

Background:

• Medication reconciliation (MR) is crucial for preventing medication errors.
• The roles of clinical pharmacists and nurses in performing MR are debated.
• Optimizing MR processes can enhance patient care and reduce adverse events.

Purpose of the Study:

• To compare the outcomes of medication reconciliation performed by clinical pharmacists versus nurses.
• To evaluate differences in medication discrepancies identified, time spent, and physician agreement.

Main Methods:

• A randomized controlled trial involving 201 cardiology patients.
• Patients were assigned to either a pharmacist group (PG) or a nurse group (NG) for MR.
• Medication discrepancies were documented, discussed with physicians, and clinically relevant ones assessed retrospectively.

Main Results:

• No statistically significant difference in the number of medication discrepancies identified between pharmacists and nurses.
• Pharmacists spent significantly less time on MR per patient compared to nurses (22.9 min vs. 32.2 min).
• Physicians showed significantly higher agreement to act on discrepancies identified by pharmacists (P < 0.001).

Conclusions:

• While both professionals identified similar numbers of medication discrepancies, pharmacist-led MR was more time-efficient.
• Increased physician agreement with pharmacist-identified discrepancies suggests potential for improved clinical decision-making.
• Findings support the integration of clinical pharmacists in medication reconciliation processes for enhanced efficiency and physician collaboration.