Modeling Incremental Benefit of Medication Reconciliation on ICU Outcomes

Area of Science:

• Pharmacoeconomics
• Health Services Research
• Patient Safety

Background:

• Medication errors and discrepancies are common in hospitalized patients, leading to adverse drug events (ADEs).
• Pharmacist-led medication reconciliation (MR) is a key intervention to mitigate these discrepancies.
• Quantifying the real-world impact of MR interventions is complex and often requires modeling.

Purpose of the Study:

• To develop and implement a mathematical model for estimating the impact of medication reconciliation (MR) on adverse drug events (ADEs).
• To conduct a cost-effectiveness analysis of varying levels of MR completion rates.

Main Methods:

• A Markov chain model was utilized to simulate the effects of incremental changes in MR completion on ADEs.
• Cost-effectiveness analysis was performed based on the modeled outcomes and financial implications.

Main Results:

• Increasing MR completion rates in a 28-bed ICU reduced yearly ADEs by up to 106, depending on the baseline ADE rate.
• Financial outcomes varied significantly, ranging from $27,808 in additional costs to $1,818,440 in savings annually.
• The economic value of MR is contingent upon the baseline ADE rate and the cost associated with each ADE.

Conclusions:

• Medication reconciliation (MR) demonstrates clear clinical benefits by reducing adverse drug events (ADEs).
• For institutions with low baseline ADE rates, the financial return on investment for MR may be limited, despite clinical advantages.
• Hospitals with average to high ADE rates can achieve substantial cost savings through effective MR implementation.