Medication reconciliation at patient admission: a randomized controlled trial
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Keywords
Medication Reconciliation, Pharmaceutical Services, Randomized Controlled Trials as Topic, Brazil
Abstract
Objective: To measure length of hospital stay (LHS) in patients receiving medication reconciliation. Secondary characteristics included analysis of number of preadmission medications, medications prescribed at admission, number of discrepancies, and pharmacists interventions done and accepted by the attending physician.
Methods: A 6 month, randomized, controlled trial conducted at a public teaching hospital in southern Brazil. Patients admitted to general wards were randomized to receive usual care or medication reconciliation, performed within the first 72 hours of hospital admission.
Results: The randomization process assigned 68 patients to UC and 65 to MR. LHS was 10±15 days in usual care and 9±16 days in medication reconciliation (p=0.620). The total number of discrepancies was 327 in the medication reconciliation group, comprising 52.6% of unintentional discrepancies. Physicians accepted approximately 75.0% of the interventions.
Conclusion: These results highlight weakness at patient transition care levels in a public teaching hospital. LHS, the primary outcome, should be further investigated in larger studies. Medication reconciliation was well accepted by physicians and it is a useful tool to find and correct discrepancies, minimizing the risk of adverse drug events and improving patient safety.
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Antonio E. Mendes
Internal Medicine Department - Clinical Pharmacy Service
RPh, Pharmacist
Natália F. Lombardi
Pharmaceutical Sciences Department
RPh, Pharmacist
Vânia M. Andrzejevski
Clinics Hospital - Hospital Pharmacy Unit
RPh, Pharmacist
Gibran Frandoloso
Internal Medicine Department
MD, Auxiliar Professor
Cassyano J. Correr
Pharmaceutical Sciences Department
Pharm PhD, Adjunct Professor
Maurício Carvalho
Internal Medicine Department
MD PhD, Adjunct Professor