Development and Evaluation of Medication Reconciliation Checklist Tool to Improve Patient Safety

Abstract

Background: Medication reconciliation is a formal process for creating the most complete and accurate list possible of a patient's current medications and comparing the list to those in the patient record or medication orders. This reconciliation is done to avoid medication errors such as omissions, duplications, dosing errors, or drug interactions. The lack of precise and complete information about patient's medicines is the most common contributing factor for the precipitation of patient safety problem around the globe. Objectives: To develop a medication reconciliation checklist tool and evaluate its utility in the assessment of medication discrepancies and contributing factors Methods: A prospective observational study was carried out in the selected departments at a tertiary care hospital. A checklist tool was prepared based on the critical parameters of the reconciliation approach which was used to assess drug discrepancies during care transition and were categorized under Justified and Unjustified medicine discrepancies. Results: A total of 200 cases were reviewed out of which164 cases were identified with the scope of reconciliation and were then followed. The observed discrepancies were categorized as follows; A total of Justified Discrepancies [27] were reported (Therapeutic Equivalence: 0, Clinical Preference: 1, Medical reason: 26), and Unjustified Discrepancies [113] (Omission errors: 31, Modification of dose: 16, Incorrect drugs: 61, Therapeutic Duplication: 4, Drug interactions: 1). Conclusion: The study concluded that medication reconciliation checklist tool was helpful in identifying medication discrepancies. Execution of the medication reconciliation process by a pharmacist can improve drug and patient safety.

Keywords

• medication reconciliation
• patient safety
• justified discrepancies
• unjustified discrepancies