Medication Reconciliation and Medication Error Prevention in an Emergency Department of a Tertiary Care Hospital

Abstract

Objective: The study was conducted to assess the effectiveness of the medication reconciliation and medication error prevention in an emergency department of a tertiary care hospital. Materials and Methods: Patients of either sex, aged above 18 years admitted for more than 24 hours irrespective of their medical diagnosis and for whom medication reconciliation was done were included. Patients’ home medication charts were compared with their current admission medication charts to check the number of home medications that were being continued to be administered during their hospital stay. Each home medication that was not ordered or commented on was deemed to represent a discrepancy. The discrepancies were classified according to the criteria of the Safer Healthcare Now! Campaign and reasons for not continuing the drug were also documented. The interventions were brought to the notice of the concerned physician. Results: Of 80 patients (43 males and 37 females; mean age 61 ± 15 years), 74 patients had medication discrepancies categorised as documented intentional discrepancies, undocumented intentional discrepancies and unintentional discrepancies and 6 patients had no discrepancies. There was a statistically significant association between number of home medications and discrepancies, both undocumented intentional discrepancies (P=0.005) and unintentional discrepancies (P=0.049). Conclusion: This study recommends the need for additional resources and educational initiatives for the health care professionals to improve medication reconciliation. For effective medication reconciliation, patients or their care takers must help the physicians and other health care professionals involved in reconciliation by bringing all their home medications at the time of hospital admissions. Key words: Discrepancies, Medication reconciliation, Medication errors, Pharmacist intervention.