Medication discrepancies in the dental record and impact of pharmacist-led intervention

Abstract

Patients frequently use medications with potential implications for oral health and dental procedures, yet little is known about the accuracy of medication lists available to dentists. The aims of this study were to describe the frequency and clinical implications of medication discrepancies in the dental record (phase 1) and to evaluate the impact of pharmacist intervention on medication reconciliation processes in dental practice (phase 2). A prospective, single-centre study evaluating adults receiving dental care was conducted. Discrepancies between the dental record and patient-reported medications were identified through a pharmacist-led medication review and were further evaluated for potential clinical significance based on drug-induced orofacial adverse-effect profiles. A multifaceted pharmacist-led intervention was implemented. Data were analysed using Poisson regression with a significance level set at 0.05. One-hundred and thirty patients (48% women; mean age 57 years) were interviewed by a clinical pharmacist (100 before intervention and 30 at follow-up). Of 860 medications reported, 618 discrepancies were identified, medication omission being the most common (71.7%). Of medications omitted, 64.6% had potential oral adverse effects, 7.9% could interact with local anaesthetics/vasoconstrictors and 19.1% had potential bleeding effects. The intervention resulted in a reduction in the number of medication discrepancies and medication omissions (P < 0.001). Medication discrepancies in the dental record occur at an alarming rate and frequently involve medications known to cause oral health problems or complications with dental procedures. A pharmacist-led intervention targeting medication reconciliation processes is an effective strategy for improving the accuracy of the dentist's medication list.