OBJECTIVE To measure length of hospital stay (LHS) in patients receiving medication reconciliation. Secondary characteristics included analysis of number of preadmission medications, medications prescribed at admission, number of discrepancies, and pharmacists interventions done and accepted by the attending physician. METHODS A 6 month, randomized, controlled trial conducted at a public teac...

The Australian Pharmaceutical Advisory Committee guidelines call for a detailed medication history to be taken at the first point of admission to hospital. Accurate medication histories are vital in optimising health outcomes and have been shown to reduce mortality rates. This study aimed to examine the accuracy of medication histories taken in the Emergency Department of the Royal Adelaide Hos...

canadianhealthcarenetwork.ca Adverse drug events and medication discrepancies continue to be a patient safety challenge for patients and healthcare professionals. Vulnerable moments, defined as points in time when a patient is at high risk for medication discrepancies, often occur at interfaces of care when a patient moves from one healthcare setting to another, such as admission and discharge ...

OBJECTIVE To evaluate the efficacy of a secure web-based patient portal called Patient Gateway (PG) in producing more accurate medication lists in the electronic health record (EHR), and whether sending primary care physicians (PCPs) a clinical message updating them on the information their patients provided caused physicians to update the EHR medication list. METHODS We compared the medicati...

UNLABELLED The Joint Commission continues to emphasize the importance of medication reconciliation in all practice settings. Pharmacists and student pharmacists are uniquely trained in this aspect of patient care, and can assist with keeping accurate and complete medication records through patient interview in the outpatient setting. OBJECTIVE The objective of this study was to quantify and d...

BACKGROUND In the hospital setting, postoperative admission is a key vulnerable moment when patients are at increased risk of medication discrepancies. This study measures the reduction of medication discrepancies associated with a combined intervention of structured pharmacist medication history interviews with assessments in a surgical preadmission clinic and a postoperative medication order ...

OBJECTIVE To systematically review all primary care intervention studies designed to implement medication reconciliation for effects on medication discrepancies, clinical outcomes, and patient knowledge of their medications. DATA SOURCES We searched MEDLINE (1988-March 2008); Healthstar (1966-March 2008); CINAHL (1982-March 2008); EMBASE (1980-March 2008); Cochrane Database of Systematic Revi...