Medication discrepancies despite pharmacist led medication reconciliation: the challenges of maintaining an accurate medication list in primary care

Medication discrepancies despite pharmacist led medication reconciliation: the challenges of maintaining an accurate medication list in primary care

Objective: Describe the types of medication discrepancies that persist despite pharmacist-led medication reconciliation using the primary care electronic medical record (EMR). Methods: Observational case series study of established patients from an urban, indigent care clinic. Medication reconciliation was conducted immediately prior to the physician visit at baseline and return visit. Main outcome measures included: frequency, types, and reasons for discrepancies, patient knowledge, and adherence. Results: There was a 14.5% reduction in the number of patients with a discrepancy and the frequency of discrepancies was reduced by 7.3%. The rate of medication discrepancies in the chart was reduced by 31.3%. The most common type of discrepancy that persisted at follow up were medications listed on the chart that the patient stopped taking. Discrepancies were more likely to persist in Caucasian subjects when compared to African Americans. Conclusion: While pharmacist led medication reconciliation appears effective at reducing the likelihood of a medication discrepancy in the EMR, challenges persist in maintaining this accuracy specifically as it relates to patient driven changes to the medication regimen.

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Main Authors: Stewart,Autumn L., Lynch,Kevin J.
Format: Digital revista
Language:English
Published: Centro de Investigaciones y Publicaciones Farmacéuticas 2014
Online Access:http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1885-642X2014000100004
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spelling oai:scielo:S1885-642X20140001000042017-01-23Medication discrepancies despite pharmacist led medication reconciliation: the challenges of maintaining an accurate medication list in primary careStewart,Autumn L.Lynch,Kevin J. Medication Reconciliation Electronic Health Records Medication Errors Continuity of Patient Care United States Objective: Describe the types of medication discrepancies that persist despite pharmacist-led medication reconciliation using the primary care electronic medical record (EMR). Methods: Observational case series study of established patients from an urban, indigent care clinic. Medication reconciliation was conducted immediately prior to the physician visit at baseline and return visit. Main outcome measures included: frequency, types, and reasons for discrepancies, patient knowledge, and adherence. Results: There was a 14.5% reduction in the number of patients with a discrepancy and the frequency of discrepancies was reduced by 7.3%. The rate of medication discrepancies in the chart was reduced by 31.3%. The most common type of discrepancy that persisted at follow up were medications listed on the chart that the patient stopped taking. Discrepancies were more likely to persist in Caucasian subjects when compared to African Americans. Conclusion: While pharmacist led medication reconciliation appears effective at reducing the likelihood of a medication discrepancy in the EMR, challenges persist in maintaining this accuracy specifically as it relates to patient driven changes to the medication regimen.Centro de Investigaciones y Publicaciones FarmacéuticasPharmacy Practice (Granada) v.12 n.1 20142014-03-01journal articletext/htmlhttp://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1885-642X2014000100004en
institution SCIELO
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country España
countrycode ES
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libraryname SciELO
language English
format Digital
author Stewart,Autumn L.
Lynch,Kevin J.
spellingShingle Stewart,Autumn L.
Lynch,Kevin J.
Medication discrepancies despite pharmacist led medication reconciliation: the challenges of maintaining an accurate medication list in primary care
author_facet Stewart,Autumn L.
Lynch,Kevin J.
author_sort Stewart,Autumn L.
title Medication discrepancies despite pharmacist led medication reconciliation: the challenges of maintaining an accurate medication list in primary care
title_short Medication discrepancies despite pharmacist led medication reconciliation: the challenges of maintaining an accurate medication list in primary care
title_full Medication discrepancies despite pharmacist led medication reconciliation: the challenges of maintaining an accurate medication list in primary care
title_fullStr Medication discrepancies despite pharmacist led medication reconciliation: the challenges of maintaining an accurate medication list in primary care
title_full_unstemmed Medication discrepancies despite pharmacist led medication reconciliation: the challenges of maintaining an accurate medication list in primary care
title_sort medication discrepancies despite pharmacist led medication reconciliation: the challenges of maintaining an accurate medication list in primary care
description Objective: Describe the types of medication discrepancies that persist despite pharmacist-led medication reconciliation using the primary care electronic medical record (EMR). Methods: Observational case series study of established patients from an urban, indigent care clinic. Medication reconciliation was conducted immediately prior to the physician visit at baseline and return visit. Main outcome measures included: frequency, types, and reasons for discrepancies, patient knowledge, and adherence. Results: There was a 14.5% reduction in the number of patients with a discrepancy and the frequency of discrepancies was reduced by 7.3%. The rate of medication discrepancies in the chart was reduced by 31.3%. The most common type of discrepancy that persisted at follow up were medications listed on the chart that the patient stopped taking. Discrepancies were more likely to persist in Caucasian subjects when compared to African Americans. Conclusion: While pharmacist led medication reconciliation appears effective at reducing the likelihood of a medication discrepancy in the EMR, challenges persist in maintaining this accuracy specifically as it relates to patient driven changes to the medication regimen.
publisher Centro de Investigaciones y Publicaciones Farmacéuticas
publishDate 2014
url http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1885-642X2014000100004
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AT lynchkevinj medicationdiscrepanciesdespitepharmacistledmedicationreconciliationthechallengesofmaintaininganaccuratemedicationlistinprimarycare
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