Literature DB >> 35847464

Impact of Pharmacist-Directed Medication Reconciliation in Reducing Medication Discrepancies: A Randomized Controlled Trial.

Khawla Abu Hammour1, Rana Abu Farha2, Rawan Ya'acoub3, Zeinab Salman3, Iman Basheti4.   

Abstract

Background: In hospital surgical wards, patients are at higher risk for medication errors, in part because physicians may not consider themselves sufficiently trained to prescribe medications. Hence, collaborative teamwork involving the pharmacist is needed.
Objectives: To assess the impact of medication reconciliation directed by pharmacists on decreasing medication discrepancies after discharge from the surgical ward.
Methods: Patients admitted to the surgical unit at a tertiary teaching hospital in Amman, Jordan, between July 2017 and July 2018 were selected and randomly assigned to either the control or the intervention group. Upon admission, the number and kinds of unintentional medication discrepancies were determined for both groups. Medication reconciliation was then provided to patients in the intervention group. The number of unintentional discrepancies was re-evaluated upon discharge for both groups. To assess differences between the control and intervention groups, the χ2 or Fisher exact test was used for categorical variables and an independent-sample t test for continuous data. A paired t test was conducted to determine whether the number of medication discrepancies was reduced as a result of pharmacists' recommendations.
Results: A total of 123 patients met the inclusion criteria, 61 in the intervention group and 62 in the control group. Discrepancies of omission and wrong dose constituted 41 (77%) of the 53 discrepancies in the intervention group and 25 (76%) of the 33 discrepancies in the control group. The number of unintentional discrepancies was significantly reduced from admission to discharge in both the intervention group (p = 0.002) and the control group (p = 0.007). Of 53 recommendations made by pharmacists, 20 (38%) were accepted by the treating physician, and all of these discrepancies were resolved. Conclusions: This study sheds light on the existence of unintentional medication discrepancies upon admission for surgical patients, which may expose the patients to potential harm upon discharge from hospital. Additional studies with a larger sample size are needed to gain further insights on pharmacists' role in implementing medication reconciliation for surgical patients. 2022 Canadian Society of Hospital Pharmacists. All content in the Canadian Journal of Hospital Pharmacy is copyrighted by the Canadian Society of Hospital Pharmacy. In submitting their manuscripts, the authors transfer, assign, and otherwise convey all copyright ownership to CSHP.

Entities:  

Keywords:  bilan comparatif des médicaments; chirurgie; discrepancies; divergences; medication reconciliation; pharmaciens; pharmacists; surgery

Year:  2022        PMID: 35847464      PMCID: PMC9245405          DOI: 10.4212/cjhp.3143

Source DB:  PubMed          Journal:  Can J Hosp Pharm        ISSN: 0008-4123


  30 in total

Review 1.  Identifying high-risk medication: a systematic literature review.

Authors:  Eva A Saedder; Birgitte Brock; Lars Peter Nielsen; Dorthe K Bonnerup; Marianne Lisby
Journal:  Eur J Clin Pharmacol       Date:  2014-03-27       Impact factor: 2.953

Review 2.  Medication review and reconciliation with cooperation between pharmacist and general practitioner and the benefit for the patient: a systematic review.

Authors:  Marlies M E Geurts; Jaap Talsma; Jacobus R B J Brouwers; Johan J de Gier
Journal:  Br J Clin Pharmacol       Date:  2012-07       Impact factor: 4.335

3.  Drug-therapy problems, inconsistencies and omissions identified during a medication reconciliation and seamless care service.

Authors:  Ann Nickerson; Neil J MacKinnon; Nancy Roberts; Lauza Saulnier
Journal:  Healthc Q       Date:  2005

4.  Unintended medication discrepancies at the time of hospital admission.

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

5.  Adverse drug events in surgical patients: an observational multicentre study.

Authors:  Monica de Boer; Eveline B Boeker; Maya A Ramrattan; Jordy J S Kiewiet; Marcel G W Dijkgraaf; Marja A Boermeester; Loraine Lie-A-Huen
Journal:  Int J Clin Pharm       Date:  2013-05-31

6.  Pharmacist provided medicines reconciliation within 24 hours of admission and on discharge: a randomised controlled pilot study.

Authors:  Brit Cadman; David Wright; Amanda Bale; Garry Barton; James Desborough; Eman A Hammad; Richard Holland; Helen Howe; Ian Nunney; Lisa Irvine
Journal:  BMJ Open       Date:  2017-03-16       Impact factor: 2.692

7.  The prevalence and clinical seriousness of medication discrepancies identified upon hospital admission of pediatric patients.

Authors:  Rana Abu Farha; Khawla Abu Hammour; Sayida Al-Jamei; Raja AlQudah; Mohammed Zawiah
Journal:  BMC Health Serv Res       Date:  2018-12-14       Impact factor: 2.655

8.  Medication histories documentation at the community pharmacy setting: A study from Jordan.

Authors:  Rana Abu Farha; Khawla Abu Hammour; Tareq Mukattash; Raja Alqudah; Rand Aljanabi
Journal:  PLoS One       Date:  2019-10-22       Impact factor: 3.240

9.  Incidence of Medication Discrepancies and Its Predicting Factors in Emergency Department.

Authors:  Morvarid Zarif-Yeganeh; Mansoor Rastegarpanah; Gholamreza Garmaroudi; Molouk Hadjibabaie; Hojjat Sheikh Motahar Vahedi
Journal:  Iran J Public Health       Date:  2017-08       Impact factor: 1.429

10.  Medication discrepancies identified during medication reconciliation among medical patients at a tertiary care hospital.

Authors:  Isra Al-Rashoud; Maha Al-Ammari; Hisham Al-Jadhey; Abdulmalik Alkatheri; Gregory Poff; Tariq Aldebasi; Salah AbuRuz; Abdulkareem Al-Bekairy
Journal:  Saudi Pharm J       Date:  2017-05-20       Impact factor: 4.330

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