Impact of pharmacist driven medication reconciliation in psychiatric emergency services on length of stay, medication errors, and medication discrepancies

Abstract

Medication reconciliation (MR) is an effective method for reducing medication errors in health care settings. The literature regarding MR impact on patient length of stay is currently limited; as is evidence of the impact of MR in psychiatric patient populations. The primary objective of this study was to determine if pharmacist-conducted MR has an effect on inpatient length of stay in a psychiatric patient population. Rates of medication errors on admission and discrepancies at discharge were also evaluated. This single center pilot study evaluated the impact of MR by utilizing three study periods. The first was a retrospective period (RP) consistent with usual care without MR, the second was a first prospective period (PP1) in which MR was completed in psychiatric emergency services, and the third was a second prospective period (PP2) in which all patients admitted to an inpatient psychiatric unit had MR performed within 24 h of admission. For the primary outcome, medians were compared using Mann–Whitney U Test. For secondary outcomes, medians were compared using a generalized linear model for non-parametric data. A total of 198 patients were included between the three study periods. There was a non-statistically significant difference in median length of stay for PP1 and PP2 compared to RP (− 0.17; P = 0.455 and − 0.18; P = 0.168, respectively). A statistically significant decrease in both the number of medication errors and discrepancies between RP and PP1 (P < 0.001 for both outcomes) and between RP and PP2 (P < 0.001 for both outcomes), was observed. MR in a psychiatric population either prior to admission or within 24 h of admission did not reduce inpatient length of stay, however it significantly reduced medication errors and discrepancies at discharge.