Medication reconciliation in in-patients with chronic pathologies: a narrative review

Abstract

Objective: To analyze the effectiveness of the medication reconciliation process by pharmacists at the hospital level in patients with chronic non-communicable diseases, evidenced through the analysis of readmissions and the acceptance of pharmaceutical interventions. Method: A narrative bibliographic review was conducted in databases of the University of Concepción between 2011 and 2021. Keywords used in the search included medication reconciliation, hospital readmission, clinical pharmacy, discrepancy, among others. The search was conducted in both English and Spanish. Clinical studies, trials, descriptive observational studies, and analytical observational studies (case and control reports) were included, involving a population over 18 years old with chronic or non-communicable diseases and reconciliation at admission, during the stay, and at hospital discharge. Results: A total of 36 articles were reviewed, of which only 23 compared the impact on unplanned readmissions within 30 days of hospital discharge, and 4 mentioned visits to the emergency department during the same period. Only 15 articles presented physician acceptance of interventions carried out by pharmacists during the medication reconciliation process, with an acceptance rate of at least 60%. Conclusions: Based on this bibliographic review, it can be concluded that medication reconciliation has an impact on the quality of care. This is reflected in a reduction in both the number of visits to the emergency department and hospital readmissions during the 30 days following discharge.