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Medication Reconciliation at Hospital Admission: Proactive Versus Retroactive Models

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Abstract

Background

The medication reconciliation (MedRec) process conducted at hospital admission uses either a proactive or retroactive model. Many hospitals have experienced challenges with MedRec, particularly its proactive model.

Objective

The aim of this study was to analyze and quantify the retroactive and proactive MedRec models.

Settings

The study was conducted at Campbellton Regional Hospital, a member of Vitalité Health Network in Canada.

Method

This prospective, observational study was conducted at Regional Hospital over a 3-month period. All patients undergoing MedRec during this time were included.

Main Outcome Measure

The primary endpoint was to compare the time components of the process for the two models, while the secondary endpoint was to determine the types of intentional and unintentional medication discrepancies.

Results

After 249 MedRecs had been reviewed, 180 patients were enrolled. The total number of medications reconciled was 2118. Of the 180 patients, 84 (46%) were evaluated using the proactive model. The median time from admission to the MedRec process was significantly shorter for the proactive model (48 min) than the retroactive model (1135 min) [p < 0.001]. The percentage of documented intentional medication modifications in the proactive model (16.3%) was more than twice that in the retroactive model (7.3%) [p < 0.001]. Patients evaluated by the proactive model had a significantly shorter hospital stay than those evaluated by the retroactive model (p < 0.001).

Conclusion

This study demonstrated that implementation of the proactive model was feasible. Compared with the retroactive model, the proactive model had a positive impact on preventing discrepancies with timeliness and efficiency.

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Acknowledgments

The authors would like to thank their Pharmacists and Pharmacy Technicians for their efforts and contributions in establishing this study.

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Authors and Affiliations

  1. Campbellton Regional Hospital, Vitalité Health Network, Campbellton, NB, Canada

    Tania Levesque, Hani Abdelaziz, Alyson Smith, Nancy Cormier, Maryse Bernard & Michèle Laplante

  2. Vitalité Health Network, Campbellton, NB, Canada

    Josee Gagnon

Authors
  1. Tania Levesque
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  2. Hani Abdelaziz
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  3. Alyson Smith
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  4. Nancy Cormier
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  5. Maryse Bernard
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  6. Michèle Laplante
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  7. Josee Gagnon
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Corresponding author

Correspondence to Hani Abdelaziz.

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Funding

No funding was provided for this research.

Conflict of interest

Tania Levesque, Hani Abdelaziz, Alyson Smith, Nancy Cormier, Maryse Bernard, Michèle Laplante and Josee Gagnon declare they have no conflicts of interest.

Ethics approval

Ethical approval was granted by the Research Ethics Board.

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Author contributions

TL contributed to the project idea, study conception, analysis of data discrepancy and manuscript review. HA contributed to study conception and design and data and statistical analysis, and drafted and reviewed the manuscript. AS was involved in data collection and edited and reviewed the manuscript. NC, MB and ML were involved in analysis of data discrepancy and manuscript review. JG contributed to the project idea, study conception and manuscript review. All authors reviewed the manuscript and approved submission of this draft for publication.

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Levesque, T., Abdelaziz, H., Smith, A. et al. Medication Reconciliation at Hospital Admission: Proactive Versus Retroactive Models. Drugs Ther Perspect 37, 545–551 (2021). https://doi.org/10.1007/s40267-021-00872-9

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  • DOI: https://doi.org/10.1007/s40267-021-00872-9

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