Impact of an integrated medication reconciliation model led by a hospital clinical pharmacist on the reduction of post‐discharge unintentional discrepancies

2021 ◽  
Author(s):  
Ivana Marinović ◽  
Vesna Bačić Vrca ◽  
Ivana Samardžić ◽  
Srećko Marušić ◽  
Ivica Grgurević ◽  
...  
Keyword(s):  
Clinical Pharmacist ◽  
Medication Reconciliation ◽  
Post Discharge

Developing a decision rule to optimise clinical pharmacist resources for medication reconciliation in the emergency department

2017 ◽  
Vol 34 (8) ◽  
pp. 502-508 ◽  
Author(s):  
Sabrina De Winter ◽  
Peter Vanbrabant ◽  
Pieter Laeremans ◽  
Veerle Foulon ◽  
Ludo Willems ◽  
...  
Keyword(s):  
Emergency Department ◽  
Decision Rule ◽  
Clinical Pharmacist ◽  
Medication Reconciliation

scholarly journals CLINICAL PHARMACIST-LED PROGRAM ON MEDICATION RECONCILIATION AND PATIENT COUNSELING IN THE DEPARTMENT OF GASTROENTEROLOGY

2019 ◽  
pp. 6-10
Author(s):  
U. KRUTHIKA ◽  
M. SUDHASREE ◽  
J. MOUNIKA ◽  
N. TANDAVA KRISHNA ◽  
M. DIVYA ◽  
...  
Keyword(s):  
Patient Safety ◽  
Sample Size ◽  
Clinical Pharmacist ◽  
Medication Reconciliation ◽  
Patient Counseling ◽  
Interventional Study ◽  
Total Prevalence ◽  
Study Population ◽  
Male Patients

Objective: To study the effects of medication reconciliation and patient counseling on the overall health benefits of the patients in the department of gastroenterology. Methods: This study is a prospective interventional study, was conducted in a 500 bedded MNR Hospital. The sample size taken was 150 patients and the study population comprised of patients aged 18-80 y, admitted in the hospital during the study period of six months. Results: Out of 150 patients, there were 98 (65.33%) male patients and 52 (34.67%) female patients. Patients between 18 and 30 y of age were 29(19.33%), between the age of 30 and 50 y were 71 (47.33%) and above 50 were 50(33.33%). Pancreatitis was most prevalent with 21% of total prevalence, followed by CLD and cholelithiasis with 17%, then IBD 16%, PUD and Gastritis 5%, GERD 4% and other diseases 15%. Conclusion: The basic role of the pharmacist, is to help in minimizing the errors and to perform medication reconciliation. In patient counseling, pharmacists provide information about the disease, and the medications to increase patient safety and the changes in the behavior for the better outcome.

scholarly journals Successful care transitions for older people: a systematic review and meta-analysis of the effects of interventions that support medication continuity

2020 ◽  
Vol 49 (4) ◽  
pp. 558-569 ◽  
Author(s):  
Justine Tomlinson ◽  
V-Lin Cheong ◽  
Beth Fylan ◽  
Jonathan Silcock ◽  
Heather Smith ◽  
...  
Keyword(s):  
Hospital Readmission ◽  
Older Patients ◽  
Medication Reconciliation ◽  
Meta Analysis ◽  
Hospital Readmissions ◽  
Transitions Of Care ◽  
Self Management ◽  
Multiple Time ◽  
Post Discharge

Abstract Background medication-related problems occur frequently when older patients are discharged from hospital. Interventions to support medication use have been developed; however, their effectiveness in older populations are unknown. This review evaluates interventions that support successful transitions of care through enhanced medication continuity. Methods a database search for randomised controlled trials was conducted. Selection criteria included mean participant age of 65 years and older, intervention delivered during hospital stay or following recent discharge and including activities that support medication continuity. Primary outcome of interest was hospital readmission. Secondary outcomes related to the safe use of medication and quality of life. Outcomes were pooled by random-effects meta-analysis where possible. Results twenty-four studies (total participants = 17,664) describing activities delivered at multiple time points were included. Interventions that bridged the transition for up to 90 days were more likely to support successful transitions. The meta-analysis, stratified by intervention component, demonstrated that self-management activities (RR 0.81 [0.74, 0.89]), telephone follow-up (RR 0.84 [0.73, 0.97]) and medication reconciliation (RR 0.88 [0.81, 0.96]) were statistically associated with reduced hospital readmissions. Conclusion our results suggest that interventions that best support older patients’ medication continuity are those that bridge transitions; these also have the greatest impact on reducing hospital readmission. Interventions that included self-management, telephone follow-up and medication reconciliation activities were most likely to be effective; however, further research needs to identify how to meaningfully engage with patients and caregivers to best support post-discharge medication continuity. Limitations included high subjectivity of intervention coding, study heterogeneity and resource restrictions.

The role of clinical pharmacist trainees in medication reconciliation process at hospital admission

2020 ◽  
Vol 42 (2) ◽  
pp. 796-804
Author(s):  
Qian Guo ◽  
Hui Guo ◽  
Junli Song ◽  
Donghong Yin ◽  
Yan Song ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Clinical Pharmacist ◽  
Medication Reconciliation ◽  
Reconciliation Process

scholarly journals Interventions to address medication-related causes of hospital readmissions: A scoping review

2019 ◽  
Vol 8 (4) ◽  
pp. 10
Author(s):  
Nathan W. Carroll ◽  
Reena Joseph ◽  
Neeraj Puro
Keyword(s):  
Medication Reconciliation ◽  
Clinical Training ◽  
Discharge Planning ◽  
Hospital Readmissions ◽  
Significant Proportion ◽  
Future Research ◽  
Post Discharge ◽  
Academic Medical ◽  
Reduction Strategies ◽  
Intervention Patient

Unplanned readmissions pose a tremendous burden on patients, providers, and payers.  A significant proportion of readmissions are medication-related.  Despite the availability of literature regarding hospital-level strategies to reduce readmissions, little has been written about strategies aimed at medication-related readmissions.  We sought to identify successful readmission reduction strategies by performing a scoping literature review of research published between 2000 and 2017.  We identified 21 studies that met our inclusion criteria.  From these studies, we identified 7 components frequently employed as a part of interventions to reduce medication-related readmissions: discharge planning, discharge education, post-discharge telephone calls, the use of a professional coordinator with clinical training to administer the intervention, patient education efforts, provider training efforts, and medication reconciliation.  Thirty-eight percent of all the interventions identified were associated with a statistically significant reduction in readmissions.  Of the 7 common intervention components we identified, none were consistently associated with intervention success in the full sample.  However, interventions implemented by inpatient hospitals, in particular academic medical centers, had a higher success rate than interventions implemented by other providers.   We examined a subsample of larger studies and found that discharge planning and medication reconciliation components were included in most of the successful interventions.  Future research should look beyond simply identifying components included in an intervention and should instead seek to identify contextual factors that enable or inhibit the success of these components.  Research examining discharge planning and medication reconciliation efforts will be particularly important.

Evaluation of Early Versus Late Postdischarge Medication Reconciliation on Readmission Rates and Emergency Department Visits

2017 ◽  
Vol 31 (3) ◽  
pp. 279-283 ◽  
Author(s):  
Tina Joseph ◽  
Rebecca A. Barros ◽  
Elise Kim ◽  
Bupendra Shah
Keyword(s):  
Emergency Department ◽  
Clinical Pharmacist ◽  
Medication Reconciliation ◽  
Emergency Department Visits ◽  
Optimal Timing ◽  
Significant Difference ◽  
The Impact ◽  
Late Group ◽  
Hospital Use

Background: The current literature speculates ideal postdischarge follow-up focusing on transitions from hospital to home can range anywhere between 48 hours and 2 weeks. However, there is a lack of evidence regarding the optimal timing of follow-up visit to prevent readmissions. Objective: The purpose of this study is to evaluate the impact of early (<48 hours) versus late (48 hours-14 days) postdischarge medication reconciliation on readmissions and emergency department (ED) use. Methods: In this retrospective study, data for patients who had a clinic visit with a primary care provider (PCP), clinical pharmacist, or both for postdischarge medication reconciliation were reviewed. Primary outcome included hospital use rate at 30 days. Secondary outcomes included hospital use rate at 90 days and hospital use rate with a postdischarge PCP follow-up visit, clinical pharmacist, or both at 30 days. Results: One hundred sixty patients were included in the analysis: 31 early group patients and 129 late group patients. There was no significant difference on hospital use at 30 days in patients who received early or late groups (32.3% vs 21.8%, P = .947). There was also no significant difference on hospital use at 90 days in patients in early versus late group (51.6% vs 50.3%, P = .842). The type of provider (PCP vs pharmacists) conducting postdischarge medication reconciliation did not show significance on hospital use at 30 days (19.9% vs 21.4%, P = .731). Conclusion: Results from this study suggest patients can be seen up to 14 days postdischarge for medication reconciliation with no significant difference on hospital use.

scholarly journals Development And Evaluation Of A Post-Discharge Medication Reconciliation Program

2014 ◽  
Vol 17 (3) ◽  
pp. A152
Author(s):  
A.R. Harrington ◽  
K. Calabro ◽  
K. Boesen ◽  
T.L. Warholak
Keyword(s):  
Medication Reconciliation ◽  
Post Discharge ◽  
Discharge Medication

Post-discharge Medication Reconciliation: Reduction in Readmissions in a Geriatric Primary Care Clinic

2018 ◽  
Vol 31 (10) ◽  
pp. 1790-1805 ◽  
Author(s):  
Victoria C. Liu ◽  
Insaf Mohammad ◽  
Bibban B. Deol ◽  
Ann Balarezo ◽  
Lili Deng ◽  
...  
Keyword(s):  
Usual Care ◽  
Medication Reconciliation ◽  
Primary Care Clinic ◽  
Hospital Utilization ◽  
Post Discharge ◽  
Inpatient Hospitalization ◽  
Geriatric Population ◽  
Care Clinic ◽  
Discharge Medication ◽  
Reconciliation Method

Objectives: This study aimed to evaluate hospital utilization and characterize interventions of pharmacist-led telephonic post-discharge medication reconciliation. Method: A retrospective analysis was conducted, including 833 index events in 586 geriatric patients receiving the intervention. Medicare claims were used to capture 30-day hospital utilization (admission to the emergency department, observation unit, or inpatient hospitalization) following discharge from any of these locations. Medication-related interventions were described. Results: Hospital utilization within 30 days after discharge from any location was greater for patients receiving usual care compared with the intervention (32.5% vs. 22.2%; odds ratio [OR] = 1.69, 95% confidence interval [CI] = [1.06, 2.68]). Inpatient admission within 30 days after discharge from any location was greater for those receiving usual care (14.7% vs. 6.4%; OR = 2.54, 95% CI = [1.18, 5.44]). At least one medication-related problem was identified and addressed in 89.8% of patients receiving the intervention. Discussion: A telephonic post-discharge medication reconciliation program can lead to reduction in hospital utilization in a geriatric population.

scholarly journals Role of a clinical pharmacist in cardiology units: Let's take the example of medication reconciliation (MR)!

2021 ◽  
Vol 13 (1) ◽  
pp. 151
Author(s):  
E. Musy ◽  
C. Hiel ◽  
E. Poutrain ◽  
P. Odou ◽  
P. de Groote ◽  
...  
Keyword(s):  
Clinical Pharmacist ◽  
Medication Reconciliation
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