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International Journal of Clinical Pharmacy

, Volume 34, Issue 6, pp 797–802 | Cite as

Medication reconciliation: passing phase or real need?

  • Esther Durán-GarcíaEmail author
  • Cecilia M. Fernandez-Llamazares
  • Miguel A. Calleja-Hernández
Commentary

Abstract

Medication reconciliation errors occur across transitions in patient care. Of all medication errors in a hospital, 25 % in hospitalised patients are caused by a failure to reconcile new prescriptions with ongoing home treatments. These errors are more common at discharge, but the critical moment for detecting and resolving them is at the time of admission. This commentary reviews the different ways in which reconciliation errors can be prevented. The reconciliation process should be standardised and implemented in daily practice as a routine part of healthcare provision. To achieve this, professional development of hospital pharmacists is of paramount importance. The commentary goes on to describe the factors that affect the reconciliation process and the stages involved in its implementation. Finally, we discuss the use of information technology as a means to help integrating medication reconciliation into clinical practice.

Keywords

Chronic medication Information technology Levels of care Medication errors Medication reconciliation Seamless care 

Notes

Acknowledgments

The authors would like to thank A.B. Jiménez and F. Martínez for their contribution to the initial planning of this article and A. Giménez for their contribution to the literature search.

Funding

None.

Conflicts of interest

The authors declare that they have no conflicts of interest.

References

  1. 1.
    Kohn LT, Corrigan JM, Donaldson MS (Institute of Medicine). To err is human: Building a safer health system. Washington, DC: National Academy Press; 2000.Google Scholar
  2. 2.
    Aranaz JM, Aibar C, Vitaller J, Ruiz P. Estudio Nacional sobre los Efectos Adversos ligados a la hospitalización. ENEAS, 2005. Madrid: Ministerio de Sanidad y Consumo; 2006.Google Scholar
  3. 3.
    American Society of Hospital Pharmacists. ASHP guidelines on preventing medication errors in hospitals. Am J Hosp Pharm. 1993;50:305–14.Google Scholar
  4. 4.
    Tam VC, Knowles SR, Cornish PL, Fine N, Marchesano R, Etchells EE. Frequency, type and clinical importance of medication history errors at admission to hospital: a systematic review. CMAJ. 2005;173:510–5.PubMedCrossRefGoogle Scholar
  5. 5.
    Soler-Giner E, Izuel-Rami M, Villar-Fernández I, Real JM, Carrera P, Rabanaque MJ. Quality of home medication collection in the emergency department: reconciliation discrepancies. Farm Hosp. 2011;35:165–71. Spanish.PubMedCrossRefGoogle Scholar
  6. 6.
    Karapinar-Çarkit F, Terry D. Medication reconciliation: a necessity for continuity of care. EJHP Practice. 2011;3:32–3.Google Scholar
  7. 7.
    Oakes SL, Gillespie SM, Ye Y, Finley M, Russell M, Patel NK, et al. Transitional care of the long-term care patient. Clin Geriatr Med. 2011;27:259–71.PubMedCrossRefGoogle Scholar
  8. 8.
    Delgado Sanchez O, Anoz Jimenez L, Serrano Fabia A, Nicolas Pico J, Grupo de Investigacion de la I Beca Joaquim Bonal 2006. [Conciliation in medication]. Med Clin (Barc). 2007;129:343-8. Spanish.Google Scholar
  9. 9.
    Cornish PL, Knowles SR, Marchesano R, Tam V, Shadowitz S, Juurlink DN, et al. Unintended medication discrepancies at the time of hospital admission. Arch Intern Med. 2005;165:424–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Lubowski TJ, Cronin LM, Pavelka RW, Briscoe-Dwyer LA, Briceland LL, Hamilton RA. Effectiveness of a medication reconciliation project conducted by PharmD students. Am J Pharm Educ. 2007;71(5):94.PubMedCrossRefGoogle Scholar
  11. 11.
    Pardo MA, Aznar MT, Camacho MD, González M, Martínez M, Pérez MJ, et al. Desarrollo de un programa de conciliación de la medicación: impacto sobre la prescripción médica y resultados en el paciente. El Farmacéutico Hospitales. 2008;192:33–44. Spanish.Google Scholar
  12. 12.
    Nickerson A, MacKinnon NJ, Roberts N, Saulnier L. Drug-therapy problems, inconsistencies and omissions identified during a medication reconciliation and seamless care service. Healthc Q. 2005;8:65–72. Spec No.PubMedGoogle Scholar
  13. 13.
    Medication reconciliation in acute care. Getting Started Kit [Internet]. Canada: Safer healthcare now; 2011 [cited 2011 Aug 11]. Available from: http://www.saferhealthcarenow.ca/EN/Interventions/medrec/Pages/default.aspx.
  14. 14.
    PSG001 technical patient safety solutions for medicines reconciliation on admission of adults to hospital: guidance [Internet]. London: national institute for health and clinical excellence; 2007 [cited 2011 Sept 11]. Available from: http://guidance.nice.org.uk/PSG001/Guidance/pdf/English.
  15. 15.
    Hospital: 2012 National Patient Safety Goals [Internet]. Washington DC: The Joint Commission; 2012 [cited 2012 Jun 28]. Available from: http://www.jointcommission.org/standards_information/npsgs.aspx.
  16. 16.
    Steurbaut S, Leemans L, Leysen T, De Baere E, Cornu P, Mets T, et al. Medication history reconciliation by clinical pharmacists in elderly inpatients admitted from home or a nursing home. Ann Pharmacother. 2010;44:1596–603.PubMedCrossRefGoogle Scholar
  17. 17.
    De Winter S, Spriet I, Indevuyst C, Vanbradant P, Desruelles D, Sabbe M, et al. Pharmacist- versus physician-acquired medication history: a prospective study at the emergency deparment. Qual Saf Health Care. 2010;19:371–5.PubMedCrossRefGoogle Scholar
  18. 18.
    Whittington J, Cohen H. OSF healthcare’s journey in patient safety. Qual Manag Health Care. 2004;13:53–9.PubMedGoogle Scholar
  19. 19.
    Aguilella T, Canadell L, Martín V, Richart C, García R. Estudio prospectivo de calidad de la conciliación de la medicación crónica en dos servicios hospitalarios. Aten Farm. 2010;12:346–51. Spanish.Google Scholar
  20. 20.
    Chhabra PT, Rattinger GB, Dutcher SK, Hare ME, Parsons KL, Zuckerman IH. Medication reconciliation during the transition to and from long-term care settings: a systematic review. Res Social Adm Pharm. 2012;8:60–75.PubMedCrossRefGoogle Scholar
  21. 21.
    Mueller SK, Sponsler KC, Kripalani S, Schipper JL. Hospital-based medication reconciliation practices. A systematic review. Arch Intern Med [Internet] 2012 Jun [cited 2012 Jun 27]; doi: 10.1001/archinternmed.2012.2246. Available from:http://archinte.jamanetwork.com/on 27/06/2012.
  22. 22.
    Rozich JD, Howard RJ, Justeson JM, Macken PD, Lindsay ME, Resar RK. Standardization as a mechanism to improve safety in health care. Jt Comm J Qual Saf. 2004;30:5–14.PubMedGoogle Scholar
  23. 23.
    Arora V, Kao J, Lovinger D, Seiden S, Meltzer D. Medication discrepancies in resident sign-outs and their potential to harm. J Gen Intern Med. 2007;22:1751–5.PubMedCrossRefGoogle Scholar
  24. 24.
    Grimes TC, Duggan CA, Delaney TP, Graham IM, Conlon KC, Deasy E, et al. Medication details documented on hospital discharge: cross-sectional observational study of factors associated with medication non-reconciliation. Br J Clin Pharmacol. 2011;71:449–57.PubMedCrossRefGoogle Scholar
  25. 25.
    Schnipper JL, Liang CL, Hamann C, Karson AS, Palchuk MB, McCarthy PC, et al. Development of a tool within the electronic medical record to facilitate medication reconciliation after hospital discharge. J Am Med Inform Assoc. 2011;18:309–13.PubMedCrossRefGoogle Scholar
  26. 26.
    Bassi J, Lau F, Bardal S. Use of information technology in medication reconciliation: a scoping review. Ann Pharmacother. 2010;44:885–97.PubMedCrossRefGoogle Scholar
  27. 27.
    Giménez A, Zoni AC, Rodríguez C, Durán-García E, Trovato AN, Pérez C, et al. Developing a programme for medication reconciliation at the time of admission into hospital. Int J Clin Pharm. 2011;33:603–9.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Esther Durán-García
    • 1
    Email author
  • Cecilia M. Fernandez-Llamazares
    • 1
  • Miguel A. Calleja-Hernández
    • 2
  1. 1.Pharmacy Department (Servicio de Farmacia)Hospital General Universitario Gregorio MarañónMadridSpain
  2. 2.Pharmacy Department (Servicio de Farmacia)Hospital Universitario Virgen de las NievesGranadaSpain

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