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Evaluation of a Web-Based Medication Reconciliation Application Within a Primary Care Setting: Cluster-Randomized

Michael R Gionfriddo1,2, Yirui Hu3, Bhumika Maddineni2

  • 1Division of Pharmaceutical, Administrative and Social Sciences, School of Pharmacy, Duquesne University, Pittsburgh, PA, United States.

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|January 13, 2022
PubMed
Summary

An electronic health record (EHR)-integrated application did not improve medication list accuracy for patients. While patients found the tool easy to use, staff reported implementation challenges, suggesting future improvements are needed.

Keywords:
EHRappdrugeffectivenesselectronic health recordinformation sourceinformation technologyinteroperabilitymedicationmedication safetymixed methodprimary carerandomized controlled trialreconciliationsafetysatisfaction

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Area of Science:

  • Health Informatics
  • Patient Safety
  • Clinical Decision Support

Background:

  • Patient medication lists are often inaccurate due to challenges in reconciling data from various sources.
  • Advances in interoperability and digital data collection offer potential solutions for integrating disparate information.

Purpose of the Study:

  • To evaluate the effectiveness and patient satisfaction of MedTrue (MT), an electronic health record (EHR)-integrated web-based medication reconciliation application.

Main Methods:

  • A cluster-randomized controlled trial was conducted in 6 primary care clinics.
  • Medication list accuracy was assessed using a pharmacist-collected best-possible medication history (BPMH).
  • Patient and staff perspectives were gathered through surveys and interviews.

Main Results:

  • Medication list accuracy did not significantly differ between the MT group and usual care (UC) group (8 vs 9 zero discrepancies).
  • The most common discrepancy was patients no longer taking a medication.
  • Patients reported high satisfaction with MT (average net promoter score=8/10), while staff found it beneficial but difficult to implement.

Conclusions:

  • The EHR-integrated MT application did not improve medication list accuracy compared to usual care.
  • The application was well-received by patients, indicating user-friendliness.
  • Future research should focus on application limitations and implementation strategies to enhance effectiveness.