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
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
)