PURPOSE: To study differences in outcomes of medication reconciliation (MR) when performed by clinical pharmacists compared to nurses. METHODS:201 patients (21-92 years) admitted to the Department of Cardiology at the University Hospital of North Norway, autumn 2012, were randomized into a pharmacist group (PG) and a nurse group (NG). The nurses and the pharmacists were trained for performing the MR process by an independent clinical pharmacist. Medication discrepancies (MDs) were discussed with the physicians. Time spent during the MR was recorded. An independent expert group rated clinical relevance of the MDs retrospectively. RESULTS: At least one MD was identified in 78 % and 84 % of patients in PG and NG, respectively (P = 0.269) with a mean number of MDs per patient 3.1 (SD 2.1) and 2.8 (SD 2.2), respectively (P = 0.528). Mean time spent/patient on the MR process was 22.9 min (SD 11.6) in the PG and 32.2 min (SD 20.3) in the NG (P < 0,001). Physicians agreed significantly more often to act upon the MDs presented by pharmacists compared to nurses (P = 0.001). The expert group finally assessed 48 % and 49 % of the MDs to be of the clinical relevance in the PG and the NG, respectively. CONCLUSIONS: By applying a structured method for MR, a small however not statistically significant difference in identified MDs between nurses and clinical pharmacists was revealed. The pharmacists spent significantly less time than the nurses, and physicians agreed significantly more often with the pharmacist that action should be taken on the MDs. This is important in the discussion of who to perform MR.
RCT Entities:
PURPOSE: To study differences in outcomes of medication reconciliation (MR) when performed by clinical pharmacists compared to nurses. METHODS: 201 patients (21-92 years) admitted to the Department of Cardiology at the University Hospital of North Norway, autumn 2012, were randomized into a pharmacist group (PG) and a nurse group (NG). The nurses and the pharmacists were trained for performing the MR process by an independent clinical pharmacist. Medication discrepancies (MDs) were discussed with the physicians. Time spent during the MR was recorded. An independent expert group rated clinical relevance of the MDs retrospectively. RESULTS: At least one MD was identified in 78 % and 84 % of patients in PG and NG, respectively (P = 0.269) with a mean number of MDs per patient 3.1 (SD 2.1) and 2.8 (SD 2.2), respectively (P = 0.528). Mean time spent/patient on the MR process was 22.9 min (SD 11.6) in the PG and 32.2 min (SD 20.3) in the NG (P < 0,001). Physicians agreed significantly more often to act upon the MDs presented by pharmacists compared to nurses (P = 0.001). The expert group finally assessed 48 % and 49 % of the MDs to be of the clinical relevance in the PG and the NG, respectively. CONCLUSIONS: By applying a structured method for MR, a small however not statistically significant difference in identified MDs between nurses and clinical pharmacists was revealed. The pharmacists spent significantly less time than the nurses, and physicians agreed significantly more often with the pharmacist that action should be taken on the MDs. This is important in the discussion of who to perform MR.
Authors: Stephane Steurbaut; Lies Leemans; Tinne Leysen; Eva De Baere; Pieter Cornu; Tony Mets; Alain G Dupont Journal: Ann Pharmacother Date: 2010-08-24 Impact factor: 3.154
Authors: Vincent C Tam; Sandra R Knowles; Patricia L Cornish; Nowell Fine; Romina Marchesano; Edward E Etchells Journal: CMAJ Date: 2005-08-30 Impact factor: 8.262
Authors: Leonard S Feldman; Linda L Costa; E Robert Feroli; Terry Nelson; Stephanie S Poe; Kevin D Frick; Leigh E Efird; Redonda G Miller Journal: J Hosp Med Date: 2012-02-27 Impact factor: 2.960
Authors: Patricia L Cornish; Sandra R Knowles; Romina Marchesano; Vincent Tam; Steven Shadowitz; David N Juurlink; Edward E Etchells Journal: Arch Intern Med Date: 2005-02-28
Authors: Amanda H Salanitro; Chandra Y Osborn; Jeffrey L Schnipper; Christianne L Roumie; Stephanie Labonville; Daniel C Johnson; Erin Neal; Courtney Cawthon; Alexandra Businger; Anuj K Dalal; Sunil Kripalani Journal: J Gen Intern Med Date: 2012-02-15 Impact factor: 5.128