Medication reconciliation: time to save? A cross-sectional study from one acute hospital
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Medication errors during transitional care are an important patient safety issue. Medication reconciliation is an established intervention to reduce such errors. Current evidence has not demonstrated an associated reduction in healthcare costs, however, with complexity and resource intensity being identified as issues. The aims of this study were to examine an existing process of medication reconciliation in terms of time taken, to identify factors associated with additional time, and to determine if additional time is associated with detecting errors of clinical significance.
A cross-sectional study was conducted. Issues arising during medication reconciliation incurring a time burden additional to the usual process were logged and quantified by pharmacists. Regression analyses investigated associations between patient characteristics and clinically significant errors and additional time. Cost for additional time in terms of hospital pharmacist salary was calculated.
Eighty-nine patients were included. Having a personal record of medication at admission (OR 3.30, 95% CI: (1.05 to 10.42), p = 0.004) was a significant predictor of additional time. No significant associations were found between the occurrence of clinically significant error and additional time (p > 0.05). The most common reason for additional time was clarifying issues pertaining to primary care medication information. Projected annual 5-year costs for the mean additional time of 3.75 min were €1.8–1.9 million.
Spending additional time on medication reconciliation is associated with economic burden and may not yield benefit in terms of capturing clinically significant errors. There is a need to improve communication of medication information between primary and secondary care.
KeywordsMedication reconciliation Transitional care Healthcare costs Medication error
The authors wish to acknowledge the contribution of Ms. Vicki Livingstone of the INFANT Centre UCC.
All authors fulfill the ICMJE criteria for authorship. Particular contributions are listed below.
Dr. Elaine K Walsh: Chief investigator, involved in study design, data analysis, and write up.
Dr. Ann Kirby: Involved in study design, data analysis, and write up.
Professor Patricia M Kearney: Involved in study design, and write up.
Professor Colin P Bradley: Involved in study design, data analysis, and write up.
Dr. Aoife Fleming: Involved in study design, obtaining ethical approval, data collection, and data analysis.
Dr. Kieran O’Connor: Involved in study design, data collection, and write up.
Mr. Ciaran Halleran: Involved in study design, data collection, and write up.
Mr. Timothy Cronin: Involved in data collection and data analysis.
Ms. Elaine Calnan: Involved in data collection and write up.
Ms. Patricia Sheehan: Involved in data collection and write up.
Ms. Laura Galvin: Involved in data collection and write up.
Ms. Derina Byrne: Involved in study design and data collection.
Dr. Laura J Sahm: Involved in study design, data analysis, and write up.
Compliance with ethical standards
Ethical approval was obtained from the Clinical Research Ethics Committee of the Cork Teaching Hospitals.
Conflict of interest
The authors declare that they have no conflict of interest
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