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Medication reconciliation by a pharmacy technician in a mental health assessment unit

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Abstract

Background Medication discrepancies are common when patients cross organisational boundaries. However, little is known about the frequency of discrepancies within mental health and the efficacy of interventions to reduce discrepancies. Objective To evaluate the impact of a pharmacy-led reconciliation service on medication discrepancies on admissions to a secondary care mental health trust. Setting In-patient mental health services. Methods Prospective evaluation of pharmacy technician led medication reconciliation for admissions to a UK Mental Health NHS Trust. From March to June 2012 information on any unintentional discrepancies (dose, frequency and name of medication); patient demographics; and type and cause of the discrepancy was collected. The potential for harm was assessed based on two scenarios; the discrepancy was continued into primary care, and the discrepancy was corrected during admission. Logistic regression identified factors associated with discrepancies. Main outcome measure Mean number of discrepancies per admission corrected by the pharmacy technician. Results Unintentional medication discrepancies occurred in 212 of 377 admissions (56.2 %). Discrepancies involving 569 medicines (mean 1.5 medicines per admission) were corrected. The most common discrepancy was omission (n = 464). Severity was assessed for 114 discrepancies. If the discrepancy was corrected within 16 days the potential harm was minor in 71 (62.3 %) cases and moderate in 43 (37.7 %) cases whereas if the discrepancy was not corrected the potential harm was minor in 27 (23.7 %) cases and moderate in 87 (76.3 %) cases. Discrepancies were associated with both age and number of medications; the stronger association was age. Conclusions Medication discrepancies are common within mental health services with potentially significant consequences for patients. Trained pharmacy technicians are able to reduce the frequency of discrepancies, improving safety.

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Acknowledgments

We acknowledge the support from both ward staff and pharmacy staff (including Hilary Scott, Chief Pharmacist).

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Authors and Affiliations

  1. Basildon Mental Health Unit, South Essex Partnership University NHS Foundation Trust, Nether Mayne, Basildon, Essex, SS16 5NL, UK

    Kay Brownlie & Roger Culliford

  2. Faculty of Pharmacy, The University of Sydney, Sydney, NSW, 2006, Australia

    Carl Schneider

  3. Department of Psychological Sciences, Faculty of Medicine and Health Sciences, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK

    Chris Fox

  4. Julian Hospital, Norfolk and Suffolk NHS Foundation Trust, Norwich, NR2 3TD, UK

    Chris Fox

  5. Aston University, Aston Triangle, B4 7ET, UK

    Alexis Boukouvalas

  6. Rochford Hospital, South Essex Partnership University NHS Foundation Trust, Union Lane, Rochford, SS4 1RB, UK

    Cathy Willan

  7. Aston Research Centre for Healthy Ageing (ARCHA), Aston University, Aston Triangle, B4 7ET, UK

    Ian D. Maidment

  8. Pharmacy Department, Life and Health Sciences School, Aston University, Aston Triangle, B4 7ET, UK

    Ian D. Maidment

Authors
  1. Kay Brownlie
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  2. Carl Schneider
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  3. Roger Culliford
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  4. Chris Fox
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  5. Alexis Boukouvalas
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  6. Cathy Willan
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  7. Ian D. Maidment
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Correspondence to Ian D. Maidment.

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Brownlie, K., Schneider, C., Culliford, R. et al. Medication reconciliation by a pharmacy technician in a mental health assessment unit. Int J Clin Pharm 36, 303–309 (2014). https://doi.org/10.1007/s11096-013-9875-8

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  • DOI: https://doi.org/10.1007/s11096-013-9875-8

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