American Journal of Public Health Research, 2017, Vol. 5, No. 2, 30-35
Available online at http://pubs.sciepub.com/ajphr/5/2/1
©Science and Education Publishing
DOI:10.12691/ajphr-5-2-1
Decreasing Unintended Medication Discrepancies in
Medication Reconciliation through Simple
Yet Effective Interventions
Hassan Tahir
1,*
, Nagadarshini Ramagiri Vinod
1
, Vistasp Daruwalla
2
, Muhammad Umair Malik
1
,
Nikath Zeeshan
1
, Lavanya Vuppu
1
, Thomas Simunich
3
, Medha Joshi
1
1
Temple University, Conemaugh Memorial Hospital, Johnstown, PA, USA
2
Wyne State University, Detroit Medical Center, Detroit, MI, USA
3
Statistitician, Conemaugh Memorial Hospital
*Corresponding author: hassantahir_01@hotmail.com
Abstract Background: Medication reconciliation is the process of comparing a patient's medication orders to all
of the medications that the patient has been taking. Unfortunately, medication errors are common in our health
system accounting for significant proportion of patient harm. The main objective of our study was to explore the
effect of self-designed intervention in improving the accuracy of patient current medication list in the outpatient
settings. Methods: The study designed entailed collection of data from October 2013 to March 2014. The data
collected in October (The pre-intervention) was compared to the post-intervention data in March 2014. Following
interventions were performed: Education of residents, nurses and patients, frequent reminders to the residents to
perform medication reconciliation, sending notifications to the residents who failed to perform medication
reconciliation, reminding the patients get all refills at the time of appointment and reminding the patients to bring pill
bottles at each appointment. The pre-intervention data was compared with the post-intervention data for different
types of medication errors. Normality of the variables was pre assessed. Non-parametric analysis using Fisher’s
exact test was performed for comparison of categorical variables. Conclusion: In conclusion, our intervention
improved the accuracy of patient current medication list in the electronic records as accurate as possible. For clinics
and hospitals, medication reconciliation can enhance delivery of high value cost conscious care to the patients by
reducing medication errors.
Keywords: medication reconciliation, medication error, patient harm
Cite This Article: Hassan Tahir, Nagadarshini Ramagiri Vinod, Vistasp Daruwalla, Muhammad Umair
Malik, Nikath Zeeshan, Lavanya Vuppu, Thomas Simunich, and Medha Joshi, “Decreasing Unintended
Medication Discrepancies in Medication Reconciliation through Simple Yet Effective Interventions.” American
Journal of Public Health Research, vol. 5, no. 2 (2017): 30-35. doi: 10.12691/ajphr-5-2-1.
1. Introduction
Medical errors are often inevitable. Medical reconciliation
is one of the processes where medical errors are frequently
noted. Thomsen et al in a systematic review accrued
evidence from twenty nine studies. The authors reported a
median adverse drug event of 14.9% per 1000 person
months. The preventable adverse drug event was 5.6% per
1000 person months [1]. Medication reconciliation is
commonly described as the process of comparing the
prescribed patient's medication list to the actual number of
medications that the patient has been taking.
Medication reconciliation activities have mainly
scrutinized during times of admission, transition or
immediately following hospital discharge. Different and
independent member of the medical team including nurses,
residents, pharmacy and the primary physician usually
performs medical reconciliation. This allows identifying
current medications in use, discrepancies in medications
prescribed and utilized by the patient with prompt
correction of the errors. Medical reconciliation involves
rigorous checking and patient education to make sure the
variances in medications and their unintended usage is
monitored as these inaccuracies lead to increased
readmissions and adverse drug side effects.
Majority of the patients during their hospitalization are
substantially reliant on the medical and ancillary team for
addressing their medications. The sudden burden of
managing their own medications and recovery at
discharge with inadequate supervision and assistance leads
to erroneous medication use. Such mismanagement and
medication discrepancies are further exaggerated by
factors like language barrier, severe illness, patient’s
comprehension of his medication regimen and familial
support in appropriately monitoring the regimen.
The objective of this study was to retrospectively
identify the medication discrepancies in discharged
patients by review the medication reconciliation. After
which a six months of intervention was performed during
which included educating physician and patients about the