IMPACT OF MEDICATION RECONCILIATION DURING PATIENT ADMISSION

Medication reconciliation is a tool used to identify discrepancies in drug regimens prescribed to a patient at interfaces of care. This tool has been shown to reduce medication error by identifying discrepancies of drugs prescribed to a patient. Objective: This study was performed to identify the benefits of using medication reconciliation during admission in the local setting compared to standard medication history taking. Methods: It was performed prospectively in a local tertiary hospital with ethical approval. Results: A total of 92 patients were identified in the study. A total of 584 medications were identified during the study period. From this study population, both intended (n=196) and unintended discrepancies (n=161) were identified using the medication reconciliation tool on admission compared to no discrepancies during the standard medication history taking. In this study population, discrepancies identified were mainly errors in drug omission (94.4%), frequency error (2.6%), dosing error (1.2%) and drug interaction (1.2%). Discrepancies positively correlated with number of indication (R=0.3, p=0.0001) and number of medications (R=0.48, p=0.0001). All intended discrepancies were resolved within 24 hours. Approximately half of the unintended discrepancies were resolved within 24 hours. There was a significantly higher number of discrepancies resolved within 24 hours compared to unresolved discrepancies (p=0.0001). Conclusion: This study demonstrated that medication reconciliation allowed medications to be reviewed more thoroughly and was able to reduce medication errors more effectively than standard medication history taking.