Medication reconciliation at patient admission: a randomized controlled trial

Area of Science:

• Clinical Pharmacy
• Patient Safety
• Health Services Research

Background:

• Medication reconciliation is crucial for patient safety during care transitions.
• Identifying and rectifying medication discrepancies can prevent adverse drug events.
• The impact of medication reconciliation on hospital length of stay requires further investigation.

Purpose of the Study:

• To evaluate the effect of medication reconciliation on length of hospital stay.
• To analyze medication discrepancies and pharmacist interventions.
• To assess physician acceptance of pharmacist recommendations.

Main Methods:

• A 6-month randomized controlled trial was conducted at a public teaching hospital.
• Patients were randomized to usual care or medication reconciliation within 72 hours of admission.
• Data collected included length of hospital stay, medication discrepancies, and interventions.

Main Results:

• No significant difference in length of hospital stay was observed between usual care (10±15 days) and medication reconciliation (9±16 days) groups (p=0.620).
• 327 medication discrepancies were identified in the medication reconciliation group, with 52.6% being unintentional.
• Physicians accepted approximately 75.0% of pharmacist interventions.

Conclusions:

• Medication reconciliation is a valuable tool for identifying and correcting medication discrepancies.
• Physician acceptance of medication reconciliation interventions is high.
• Further research with larger sample sizes is needed to investigate the impact on length of hospital stay and patient safety.