Pharmacy student-assisted medication reconciliation: Number and types of medication discrepancies identified by pharmacy students

Authors

DOI:

https://doi.org/10.18549/PharmPract.2021.3.2471

Keywords:

Medication Reconciliation, Students, Pharmacy, Professional Competence, Pharmaceutical Services, Medical History Taking, Hospitalization, Pharmacists, Workforce, Cross-Sectional Studies, Australia

Abstract

Background: Medication reconciliation aims to prevent unintentional medication discrepancies that can result in patient harm at transitions of care. Pharmacist-led medication reconciliation has clear benefits, however workforce limitations can be a barrier to providing this service. Pharmacy students are a potential workforce solution.

Objective: To evaluate the number and type of medication discrepancies identified by pharmacy students.

Methods: Fourth year pharmacy students completed best possible medication histories and identified discrepancies with prescribed medications for patients admitted to hospital. A retrospective audit was conducted to determine the number and type of medication discrepancies identified by pharmacy students, types of patients and medicines involved in discrepancies.

Results: There were 294 patients included in the study. Overall, 72% (n=212/294) had medication discrepancies, the most common type being drug omission. A total of 645 discrepancies were identified, which was a median of three per patient. Patients with discrepancies were older than patients without discrepancies with a median (IQR) age of 74 (65-84) vs 68 (53-77) years (p=0.001). They also took more medicines with a median (IQR) number of 9 (6-3) vs 7 (2-10) medicines per patient (p<0.001). The most common types of medicines involved were those related to the alimentary tract and cardiovascular system.

Conclusions: Pharmacy students identified medication discrepancies in over 70% of hospital inpatients, categorised primarily as drug omission. Pharmacy students can provide a beneficial service to the hospital and contribute to improved patient safety by assisting pharmacists with medication reconciliation.

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Published

2021-09-15

How to Cite

1.
Deep L, Schneider CR, Moles R, Patanwala AE, Do LL, Burke R, Penm J. Pharmacy student-assisted medication reconciliation: Number and types of medication discrepancies identified by pharmacy students. Pharm Pract (Granada) [Internet]. 2021 Sep. 15 [cited 2021 Oct. 16];19(3):2471. Available from: https://pharmacypractice.org/index.php/pp/article/view/2471

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Original Research