Implementation and Evaluation of a Pediatric Behavioral Health Medication Reconciliation Program in a Regional
Taylor Norris1, Robert Davis1, Steve Willis1
1Department of Pharmacy (TN, RD, SW, MW, AD, KN, PHL) and Department of Nursing (SJ), Brown University Health Hasbro Children's, Providence, RI.
Insights
A pharmacy-managed medication reconciliation program for pediatric behavioral health patients increased medication discrepancies identified. However, the time to complete medication reconciliation also significantly increased after program implementation.
Area of Science:
- Pediatric Emergency Medicine
- Behavioral Health Pharmacy Services
- Medication Reconciliation
Background:
- Limited data exists on pharmacy-led medication reconciliation for pediatric behavioral health patients.
- Inpatient admissions for pediatric behavioral health often originate from emergency departments.
Purpose of the Study:
- To evaluate the impact of a pharmacy-managed medication reconciliation program.
- Focus on pediatric behavioral health patients admitted via a pediatric emergency department.
Main Methods:
- Retrospective, single-center, pre-post design study.
- Compared medication reconciliation interventions and completion times before and after program implementation.
- Data collected over two 2-month periods.
Main Results:
- Significantly higher number of pharmacist interventions post-implementation (129 vs 61).
- Medication discontinuation was the most common intervention.
- Average time to complete reconciliation increased from 16.33 to 38.47 hours.
Conclusions:
- Pharmacy programs can enhance identification of medication discrepancies in this population.
- Increased time to reconciliation completion was observed post-implementation.
Objective:
Currently, there is limited information regarding the effect of a pharmacy-managed medication reconciliation program for pediatric behavioral health patients admitted to an inpatient service through a pediatric emergency department. This research aimed to determine the impact of a pediatric behavioral health medication reconciliation program in a regional tertiary care pediatric emergency department.
Methods:
This retrospective, single-center analysis evaluated the implementation of a medication reconciliation program in the pediatric behavioral health population using a pre-post design. We compared the quantity of pharmacy-initiated admission medication reconciliation interventions, the time to completion of admission medication reconciliations, and the trends in completion rates for a 2-month period before (October 1, 2022, to November 30, 2022) and after implementation (October 1, 2023, to November 30, 2023).
Results:
A total of 107 patients were included, 59 in the pre-intervention group and 48 in the post-intervention group. Between the pre-intervention and post-intervention groups, the post-intervention group had a statistically significantly higher number of interventions by pharmacists (61 vs 129, p < 0.0001). The most common pharmacy intervention made in the post-intervention group was discontinuation of the medication order. The average time to completion of admission medication reconciliation increased from 16.33 hours in the pre-intervention group to 38.47 hours in the post-intervention group (p = 0.002).
Conclusions:
Implementing a medication reconciliation program in the pediatric behavioral health population admitted through a pediatric emergency department has the potential to increase the quantity of medication discrepancies identified. Time to completion of medication reconciliation increased significantly in the post-intervention group.
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