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Medication Reconciliation: A Prospective Study in an Internal Medicine Unit

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Abstract

Background

Medication reconciliation has proved its effectiveness at improving drug-prescription safety. This study was undertaken to assess the impact of an intervention aimed at decreasing the discrepancies between a patient’s usual treatment(s) and medications prescribed at admission.

Methods

Our study was conducted from November 2010 to May 2011. Discrepancies between home medication(s) and drugs prescribed to every patient aged ≥65 years, transferred from the Emergency Department and hospitalized in the Internal Medicine Unit, were analyzed.

Results

During this 6-month period, 170 patients were prospectively included, with a total of 1,515 medicines reconciled. The unintentional discrepancy rate declined from 4.3 to 0.9 % after the intervention. The main sources of discrepancies concerned alimentary tract and metabolism (25.7 %), cardiovascular (24 %), and nervous system drugs (19.4 %).

Conclusions

The results of this study demonstrated that acquisition of patients’ medication history is often incomplete or incorrect. Pharmacists seem to be especially well suited to help medical teams rectify this situation. However, the cost effectiveness of this intervention needs further assessment.

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Acknowledgments

This work was carried out as part of the High 5s Project initiated by the WHO in 2007 and coordinated by the WHO Collaborating Center on Patient Safety. The Joint Commission in the USA, with the participation of the French Lead Technical Agency, National Health Authority (HAS) partnered with OMEDIT Aquitaine and the High 5s France Medication Reconciliation Study Group.

CT, EP, and PA designed the research. LA, CT, J-FA, CE, AM, EP, PA, and TP conducted the research. LA, CT, J-FA, CE, and EP analyzed the data. CT, J-FA, EP, PA, and TP contributed new reagents/analytical tools. LA, CT, and J-FA wrote the manuscript.

No sources of funding were used to conduct this study or for the preparation of this article.

The authors have no potential conflicts of interest that are directly relevant to the content of this study.

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Authors and Affiliations

  1. Department of Clinical Pharmacy, Bichat-Claude Bernard University Hospital, AP-HP, Paris, France

    Laura Andreoli, Chloé Tesmoingt, Charlotte Eerdekens, Philippe Arnaud & Emmanuelle Papy

  2. Department of Internal Medicine, Bichat-Claude Bernard University Hospital, AP-HP, Paris, France

    Jean-François Alexandra & Thomas Papo

  3. Department of Quality, Bichat-Claude Bernard University Hospital, AP-HP, Paris, France

    Annick Macrez

Authors
  1. Laura Andreoli
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  2. Jean-François Alexandra
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  3. Chloé Tesmoingt
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  4. Charlotte Eerdekens
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  5. Annick Macrez
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  6. Thomas Papo
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  7. Philippe Arnaud
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  8. Emmanuelle Papy
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Corresponding author

Correspondence to Jean-François Alexandra.

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Andreoli, L., Alexandra, JF., Tesmoingt, C. et al. Medication Reconciliation: A Prospective Study in an Internal Medicine Unit. Drugs Aging 31, 387–393 (2014). https://doi.org/10.1007/s40266-014-0167-3

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