Evaluation of medication reconciliation in an ambulatory setting before and after pharmacist intervention

Lauren Peyton, Kristie Ramser, Gale Hamann, Dipika Patel, David Kuhl, Laura Sprabery, Bruce Steinhauer

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objectives: To determine the accuracy of medication reconciliation in an internal medicine clinic and to evaluate pharmacist interventions targeted at improving the accuracy of medication reconciliation. Design: Prospective case series. Setting: Memphis, TN, from October 2007 to March 2008. Patients: 180 adults attending an internal medicine appointment. Intervention: On patient arrival, a nurse completed the medication reconciliation form. In Phase 1 of the study, a pharmacist randomly selected and reviewed a patient's medication reconciliation form, interviewed the patient, and verified information if indicated. A total of 90 forms were reviewed and compared to determine baseline medication reconciliation accuracy. Education interventions were held with the medical and nursing staff, targeting areas for improvement. In Phase 2 of the study, 90 additional medication reconciliation forms were reviewed in the same manner. Phase 1 and Phase 2 results were compared to evaluate differences in accuracy after the pharmacist's education interventions. Main outcome measures: Accuracy of medication reconciliation forms and number of potentially significant errors at baseline and after pharmacist interventions. Results: In Phase 1, 14.4% of medication reconciliation forms were correct. The remaining forms contained 190 potentially significant errors. After the education interventions, 18.9% of medication reconciliation forms were correct and the others contained 139 potentially significant errors. Conclusion: Medication reconciliation accuracy is poor. Although education interventions showed a trend toward improvement, continued education training for staff and patients is needed in addition to other interventions to optimize this process and prevent medication errors.

Original languageEnglish (US)
Pages (from-to)490-495
Number of pages6
JournalJournal of the American Pharmacists Association
Volume50
Issue number4
DOIs
StatePublished - Jan 1 2010

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Medication Reconciliation
Pharmacists
Education
Nursing
Internal Medicine
Medication Errors
Nursing Staff
Medical Staff
Appointments and Schedules

All Science Journal Classification (ASJC) codes

  • Pharmacology (nursing)
  • Pharmacy
  • Pharmacology

Cite this

Evaluation of medication reconciliation in an ambulatory setting before and after pharmacist intervention. / Peyton, Lauren; Ramser, Kristie; Hamann, Gale; Patel, Dipika; Kuhl, David; Sprabery, Laura; Steinhauer, Bruce.

In: Journal of the American Pharmacists Association, Vol. 50, No. 4, 01.01.2010, p. 490-495.

Research output: Contribution to journalArticle

Peyton, Lauren ; Ramser, Kristie ; Hamann, Gale ; Patel, Dipika ; Kuhl, David ; Sprabery, Laura ; Steinhauer, Bruce. / Evaluation of medication reconciliation in an ambulatory setting before and after pharmacist intervention. In: Journal of the American Pharmacists Association. 2010 ; Vol. 50, No. 4. pp. 490-495.
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