Electronic tools to support medication reconciliation: a systematic review.

Area of Science:

• Health Informatics
• Patient Safety
• Clinical Pharmacy

Background:

• Medication reconciliation (MedRec) is critical for patient safety during care transitions.
• Electronic support tools offer a promising avenue to enhance MedRec processes.
• Medication discrepancies contribute significantly to patient harm.

Purpose of the Study:

• To systematically review evidence on electronic tools supporting MedRec.
• To identify and characterize these tools based on context, design, implementation, and evaluation.
• To summarize key factors for successful development and implementation of electronic MedRec tools.

Main Methods:

• Comprehensive literature search across major databases (PubMed, CINAHL, Embase, PsycINFO, Cochrane).
• Inclusion of reports detailing electronic tools for medication history, discrepancy identification, and resolution.
• Independent study selection, quality assessment, and data extraction by two researchers.

Main Results:

• Eighteen reports on 11 distinct electronic MedRec tools were identified.
• Tools originated from North American academic settings, utilizing multi-source electronic data.
• Evaluations primarily focused on usability and user satisfaction; limited data on clinical impact (e.g., adverse drug events).
• Information on functionalities and implementation was often incomplete.

Conclusions:

• Effective implementation of electronic MedRec tools hinges on supportive context, robust tool design, and meticulous attention to implementation strategies.
• Further research is essential to rigorously evaluate the impact of these tools on healthcare quality and patient safety.