5/5/2023 0 Comments Medication reconciliationThus, although unintended medication discrepancies are common, clinically significant discrepancies may affect only a few patients. Of note, approximately 40% to 80% of patients have no clinically significant unintended medication discrepancies (8, 10–16). Reported proportions of unintended discrepancies with the potential for harm range from 11% to 59% of all discrepancies (9). As in other areas of patient safety, errors are more common than actual harms. Up to 67% of patients admitted to the hospital have unintended medication discrepancies (9), and these discrepancies remain common at discharge (7, 10). However, other discrepancies are unintentional and result from incomplete or inaccurate information about current medications and doses. Some differences reflect deliberate changes related to the conditions that led to hospitalization (for example, withholding antihypertensive medications from patients with septic shock). Medication regimens at hospital discharge often differ from preadmission medications. Unintentional changes to patients' medication regimens represent 1 well-studied category of such errors (6–9). Transitions in care, such as admission to and discharge from the hospital, put patients at risk for errors due to poor communication and inadvertent information loss (1–5). Medication reconciliation alone probably does not reduce postdischarge hospital utilization but may do so when bundled with interventions aimed at improving care transitions. Most unintentional discrepancies identified had no clinical significance. Pharmacists performed medication reconciliation in 17 of the 20 interventions. Two reviewers evaluated study eligibility, abstracted data, and assessed study quality.Įighteen studies evaluating 20 interventions met the selection criteria. Eligible studies evaluated the effects of hospital-based medication reconciliation on unintentional discrepancies with nontrivial risks for harm to patients or 30-day postdischarge emergency department visits and readmission. Searches encompassed MEDLINE through November 2012 and EMBASE and the Cochrane Central Register of Controlled Trials through July 2012. The purpose of this review is to summarize evidence about the effectiveness of hospital-based medication reconciliation interventions. Medication reconciliation identifies and resolves unintentional discrepancies between patients' medication lists across transitions in care.
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