8 Abstract Background Medication reconciliation is a 9 basic principle of good medicines management. With the 10 establishment of the National Acute Medicines Programme 11 in Ireland, medication reconciliation has been mandated for 12 all patients at all transitions of care. The clinical pharmacist 13 is widely credited as the healthcare professional that plays 14 the most critical role in the ...

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...

PURPOSE The effectiveness of a multidisciplinary medication reconciliation process was studied in an inpatient family medicine unit of an academic hospital center. METHODS In phase 1 of this two-phase study, nurses, pharmacists, and physicians used an admission medication reconciliation form to reconcile patients' home medications on admission. The form was then reviewed by the pharmacist on ...

Medication errors, drug related problems and patient safety Patient safety is arguably the most important issue facing pharmacy practice today. In this issue of the Translator the prevalence and incidence of drug related morbidities is examined, and possible solutions and the impact of medication reconciliation are discussed. ■ Seventy percent of hospitalizations for drug-related causes are dee...

BACKGROUND Therapeutic interchange of a same class medication for an outpatient medication is a widespread practice during hospitalization in response to limited hospital formularies. However, therapeutic interchange may increase risk of medication errors. The objective was to characterize the prevalence and safety of therapeutic interchange. METHODS AND FINDINGS Secondary analysis of a trans...

BACKGROUND In this study we implemented and developed state-of-the-art machine learning (ML) and natural language processing (NLP) technologies and built a computerized algorithm for medication reconciliation. Our specific aims are: (1) to develop a computerized algorithm for medication discrepancy detection between patients' discharge prescriptions (structured data) and medications documented ...

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 pe...

BACKGROUND Medication reconciliation has been identified as an important intervention to minimize the incidence of unintentional medication discrepancies at transitions in care. However, there is a lack of evidence for the impact of information technology on the rate and incidence of medication discrepancies identified during care transitions. This systematic review was thus, aimed to evaluate ...