Journal of Research in Pharmacy Practice

Pharmacy impact on medication reconciliation in the medical intensive care unit

Authors

. Brittany M. Wills 1
. William Darko 2
. Robert Seabury 2
. Luke A. Probst 2
. Christopher D. Miller 2
. Gregory M. Cwikla 2

1 Nesbitt School of Pharmacy, Wilkes University, Wilkes-Barre, PA, USA

2 Department of Pharmacy, Upstate University Hospital, Syracuse, New York, USA

Abstract
Objective: Pharmacy‑driven medication history (MH) programs have been shown 
to reduce the number of serious or potentially life‑threatening (S/PLT) medication 
discrepancies (MDs) in many settings, but not Intensive Care Units (ICUs).
Methods: MHs were repeated over a 6‑week period. Demographics, number, and nature 
of MDs were documented. Discrepancy severity was graded using a previously published 
method. Primary outcome was the proportion of MHs containing >1 S/PLT MDs.
Findings: Sixty‑three MHs were repeated. Pharmacy MHs were less likely to 
contain ≥1 S/PLT MDs (0% vs. 50%, P < 0.001).
Conclusion: Pharmacy MHs contained fewer S/PLT MDs in this small sample. S/PLT 
MDs on admission and home medication lists were common in patients admitted to 
the medical ICU. Pharmacy‑driven medication reconciliation (MR) reduced the number 
and frequency of these discrepancies. Further research is required to improve current 
MR procedures.

Keywords

Critical care
medication reconciliation
intensive care unit
REFERENCES
1. Moyen E, Camiré E, Stelfox HT. Clinical review: Medication 
errors in critical care. Crit Care 2008;12:208.
2. Kalb K, Shalansky S, Legal M, Khan N, Ma I, Hunte G. 
Unintended medication discrepancies associated with reliance 
on prescription databases for medication reconciliation on 
admission to a general medical ward. Can J Hosp Pharm 
2009;62:284‑9.
3. Smith SB, Mango MD. Pharmacy‑based medication 
reconciliation program utilizing pharmacists and technicians: 
A process improvement initiative. Hosp Pharm 2013;48:112‑9.
4. Becerra‑Camargo J, Martínez‑Martínez F, García‑Jiménez E. The 
effect on potential adverse drug events of a pharmacist‑acquired 
medication history in an emergency department: A multicentre, 
double‑blind, randomised, controlled, parallel‑group study. 
BMC Health Serv Res 2015;15:337.
5. Hart C, Price C, Graziose G, Grey J. Aprogram using pharmacy 
technicians to collect medication histories in the emergency 
department. P T 2015;40:56‑61.
6. Lancaster JW, Grgurich PE. Impact of students pharmacists 
on the medication reconciliation process in high‑risk 
hospitalized general medicine patients. Am J Pharm Educ 
2014;78:34.
7. Provine AD, Simmons EM, Bhagat PH. Establishment and 
evaluation of pharmacist‑managed admission medication 
history and reconciliation process for pediatric patients. 
J Pediatr Pharmacol Ther 2014;19:98‑102
Journal of Research in Pharmacy Practice
Volume 5, Issue 2
Spring 2016
Pages 142-145

Home

Guide for Authors

Submit Manuscript

Reviewers

Contact Us