Abstract
Background Medicines reconciliation—identifying and maintaining an accurate list of a patient’s current medications—should be undertaken at all transitions of care and available to all patients. Objective A self-completion web survey was conducted for chief pharmacists (or equivalent) to evaluate medicines reconciliation levels in secondary care mental health organisations. Setting The survey was sent to secondary care mental health organisations in England, Scotland, Northern Ireland and Wales. Method The survey was launched via Bristol Online Surveys. Quantitative data was analysed using descriptive statistics and qualitative data was collected through respondents free-text answers to specific questions. Main outcomes measure Investigate how medicines reconciliation is delivered, incorporate a clear description of the role of pharmacy staff and identify areas of concern. Results Forty-two (52 % response rate) surveys were completed. Thirty-seven (88.1 %) organisations have a formal policy for medicines reconciliation with defined steps. Results show that the pharmacy team (pharmacists and pharmacy technicians) are the main professionals involved in medicines reconciliation with a high rate of doctors also involved. Training procedures frequently include an induction by pharmacy for doctors whilst the pharmacy team are generally trained by another member of pharmacy. Mental health organisations estimate that nearly 80 % of medicines reconciliation is carried out within 24 h of admission. A full medicines reconciliation is not carried out on patient transfer between mental health wards; instead quicker and less exhaustive variations are implemented. 71.4 % of organisations estimate that pharmacy staff conduct daily medicine reconciliations for acute admission wards (Monday to Friday). However, only 38 % of organisations self-report to pharmacy reconciling patients’ medication for other teams that admit from primary care. Conclusion Most mental health organisations appear to be complying with NICE guidance on medicines reconciliation for their acute admission wards. However, medicines reconciliation is conducted less frequently on other units that admit from primary care and rarely completed on transfer when it significantly differs to that on admission. Formal training and competency assessments on medicines reconciliation should be considered as current training varies and adherence to best practice is questionable.Electronic supplementary materialThe online version of this article (doi:10.1007/s11096-015-0236-7) contains supplementary material, which is available to authorized users.
Highlights
Precise and trustworthy information about patient medication, including how well they are adhering to their medication regimen, must be obtained every time a patient is transferred from one healthcare setting to another [1]
In 2007, Medicines Reconciliation guidelines were published by The National Institute for Health and Care Excellence (NICE) in collaboration with the National Patient Safety Agency (NPSA), identifying the aim of the process: to confirm that medicines prescribed upon admission correlate to those taken by the patient prior to admission in order to reduce adverse drug events [4, 5]
This study explores the role of each staff member, with a principal focus on the pharmacy team and the variability of the procedure between organisations providing secondary care mental health services
Summary
Precise and trustworthy information about patient medication, including how well they are adhering to their medication regimen, must be obtained every time a patient is transferred from one healthcare setting to another [1] This includes: names, dosages, frequencies, and routes of administration, allowing healthcare professionals to compare the patient’s previous medication list with their current medication list [2,3,4]. And informed decisions can be made regarding the patient’s future treatment and any discrepancies can be accounted for, documented and dealt with appropriately [1, 5] This is the process of medicines reconciliation [1,2,3,4,5]. Objective A self-completion web survey was conducted for chief pharmacists (or equivalent) to evaluate medicines reconciliation levels in secondary care mental health organisations. Training procedures frequently include an induction by pharmacy for Electronic supplementary material The online version of this article (doi:10.1007/s11096-015-0236-7) contains supplementary material, which is available to authorized users
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