A medication reconciliation form and its impact on the medical record in a paediatric hospitaljep_1424 222..227 Pascal Bédard BPharm, 1 Lyne Tardif BPharm, 1 Alexandre Ferland BPharm, 1 Jean-François Bussières BPharm MSc FCSHP MBA, 2 Denis Lebel BPharm MSc FCSHP, 3 Benoit Bailey MD MSc FRCPC, 4 Marc Girard MD 5 and Jean Lachaîne PhD 6 1 Pharmacist, Department of Pharmacy, CHU Sainte-Justine, Montreal, Quebec, Canada 2 Director, Department of Pharmacy, CHU Sainte-Justine, Montreal, Quebec, Canada and Professor, Faculty of Pharmacy, Université de Montréal, Montreal, Quebec, Canada 3 Assistant Director, Department of Pharmacy, CHU Sainte-Justine, Montreal, Quebec, Canada 4 Director, Department of Pediatrics, CHU Sainte-Justine, Montreal, Quebec, Canada 5 Director, Department of Pediatrics, CHU Sainte-Justine, Montreal, Quebec, Canada 6 Professor, Faculty of Pharmacy, Université de Montréal, Montreal, Quebec, Canada Keywords drugs information, hospital, medication reconciliation, paediatric Correspondence Jean-François Bussières 3175 Chemin Côte-Ste-Catherine Montreal QC H3T 1C5 Canada E-mail: jf.bussieres@ssss.gouv.qc.ca Financial disclosure: none. Conflict of interest: none. Accepted for publication: 27 November 2009 doi:10.1111/j.1365-2753.2010.01424.x Abstract Objectives The objective of this study was to evaluate the quality of medication informa- tion available in medical charts before and after the implementation of a medication reconciliation form. Patients and methods This study is a retrospective chart review of patients under 18 years who were taking two medications or more at home and were admitted to a paediatric hospital for more than 24 hours and discharged from a general paediatrics, infectious disease, gastroenterology or pneumology ward over two 20-week periods (pre- and post- implementation). Each week, 10 medical records were randomly chosen and reviewed. The quality of the medication information was measured on admission (dose, route of admin- istration and frequency) and on discharge (dose, route of administration, frequency and duration of treatment). The proportion of medications that fully met these criteria was compared between the groups using the chi-squared test. Results Information was analysed for a total of 3275 medications in the pre- implementation group, vs. 3240 medications in the post-implementation group. Baseline characteristics were similar in both groups. On admission, the quality of medication information was comparable between the pre- and post-implementation groups (29.1 vs. 29.3%, respectively; P = 0.86). However, on discharge, an improvement in the quality of information was observed in the post-implementation group (51.7 vs. 65.2%; P < 0.001). Conclusion Our study demonstrated that the forms used in the reconciliation process, in particular the discharge prescription, could increase the quality of the information related to drug use in medical charts. We believe that medication reconciliation forms should be widely used by all the health care professional teams involved in the drug history or prescription process. Introduction In 1999, a report by the Institute of Medicine estimated that, annually, up to 98 000 fatalities in the USA were due to medical errors [1]. Medication errors, one of the most frequent medical errors, were among the major issues examined in this report [2]. While the frequency of medication errors in the paediatric popu- lation is similar to that observed in the adult population, it is estimated that the risk of serious consequences in children is three times higher [3]. One study conducted in a paediatric academic setting demonstrated that 5.7% of the prescriptions had an error and 31% of the patients were victims of at least one medication error during their hospitalization [3]. Most medication errors (78%) occurred during the prescription phase. During hospitalization, more than 40% of the prescription errors occur on admission or on discharge [4]. One study iden- tified that in more than 50% of the patients, there was at least one unintended discrepancy between the medications prescribed on admission and the medications regularly taken by the patients [5]. The most frequent error was failing to prescribe a medica- tion on admission, an error that also risked being repeated on discharge. Journal of Evaluation in Clinical Practice ISSN 1365-2753 © 2010 Blackwell Publishing Ltd, Journal of Evaluation in Clinical Practice 17 (2011) 222–227 222