Browsing by Subject "medication reconciliation"

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    Effects of Medication Reconciliation Service Provided by Student Pharmacists in a Tertiary Care Emergency Department
    (University of Minnesota, College of Pharmacy, 2013) Okere, Arinzechukwu Nkemdirim; Gessert, Charles; Renier, Collen; Swanoski, Michael
    Objective: The primary objective of this case study was to evaluate the impact of a medication reconciliation service (MRS) provided by student pharmacists in an emergency department (ED). Methods: Eligible patients were assigned to two groups, MRS or non-MRS. Patients in the MRS group were seen by student pharmacists while the non-MRS group followed usual care. As part of the services provided by the student pharmacists, medication reconciliation was provided under the supervision of a clinical pharmacist. At the conclusion of their ED visit, patients were asked to complete a survey addressing knowledge of medications, confidence in medication taking and patient satisfaction. To evaluate the impact of provision of MRS by student pharmacists on readmission rates in the ED, the electronic health records of the institution were queried for subsequent inpatient hospitalizations and ED visits. Results: Based on the study, patients in MRS group were more likely to be satisfied with the education provided to them in the ED (p=0.016) and had greater confidence in taking their medications (p=0.03). Sixty days post ED visit MRS group readmissions were significantly lower compared to non-MRS group (P= 0.047). Conclusions: Students’ participation in the provision of medication reconciliation led to reduction of readmission in the tertiary care ED, improved patient satisfaction and confidence in medication use.
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    Transitions in Care: Medication Reconciliation in the Community Pharmacy Setting After Discharge
    (University of Minnesota, College of Pharmacy, 2013) Freund, Jeff E.; Martin, Beth A.; Kieser, Mara A.; Williams, Staci M.; Sutter, Susan L.
    Objective: To assess the feasibility of a workflow process in which pharmacists in an independent community pharmacy group conduct medication reconciliation for patients undergoing transitions in care. Methods: Three workflow changes were made to improve the medication reconciliation process in a group of three independent community pharmacies. Analysis of the process included workflow steps performed by pharmacy staff, pharmacist barriers encountered during the medication reconciliation process, number of medication discrepancies identified, and pharmacist comfort level while performing each medication reconciliation service. Key Findings: Sixty patient medication reconciliation services met the inclusion criteria for the study. Pharmacists were involved in all steps associated with the medication reconciliation workflow, and were the sole performer in four of the steps: verifying discharge medications with the pharmacy medication profile, resolving discrepancies, contacting the prescriber, and providing patient counseling. Pharmacists were least involved in entering medications into the pharmacy management system, performing that workflow step 13% of the time. The most common barriers were the absence of a discharge medication list (24%) and patient not present during consultation (11%). A total of 231 medication discrepancies were identified, with an average of 3.85 medication discrepancies per discharge. Pharmacists’ comfort level performing medication reconciliation improved through the 13 weeks of the study. Conclusions: These findings suggest that medication reconciliation for patients discharged from hospitals and long term care facilities can be successfully performed in an independent community pharmacy setting. Because many medication discrepancies were identified during this transition of care, it is highly valuable for community pharmacists to perform medication reconciliation services.