Pharmacy student-assisted medication reconciliation: Number and types of medication discrepancies identified by pharmacy students
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Louise Deep [1] ; Carl R. Schneider [2] ; Rebekah Moles [2] ; Asad E. Patanwala [2] ; Linda L. DO [2] ; Rosemary Burke [3] ; Jonathan Penm [2]
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[1] Royal Prince Alfred Hospital
Royal Prince Alfred Hospital
Australia
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[2] University of Sydney
University of Sydney
Australia
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[3] Sydney Local Health District, Sydney, NSW (Australia).
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- Localización: Pharmacy Practice (Granada), ISSN-e 1886-3655, Vol. 19, Nº. 3, 2021 (Ejemplar dedicado a: Jul-Sep)
- Idioma: inglés
- Enlaces
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Resumen
Background: Medication reconciliation aims to prevent unintentional medication discrepancies that can result in patient harm at transitions of care. Pharmacist-led medication reconciliation has clear benefits, however workforce limitations can be a barrier to providing this service. Pharmacy students are a potential workforce solution.
Objective: To evaluate the number and type of medication discrepancies identified by pharmacy students.
Methods: Fourth year pharmacy students completed best possible medication histories and identified discrepancies with prescribed medications for patients admitted to hospital. A retrospective audit was conducted to determine the number and type of medication discrepancies identified by pharmacy students, types of patients and medicines involved in discrepancies.
Results: There were 294 patients included in the study. Overall, 72% (n=212/294) had medication discrepancies, the most common type being drug omission. A total of 645 discrepancies were identified, which was a median of three per patient. Patients with discrepancies were older than patients without discrepancies with a median (IQR) age of 74 (65-84) vs 68 (53-77) years (p=0.001). They also took more medicines with a median (IQR) number of 9 (6-3) vs7 (2-10) medicines per patient (p<0.001). The most common types of medicines involved were those related to the alimentary tract and cardiovascular system.
Conclusions: Pharmacy students identified medication discrepancies in over 70% of hospital inpatients, categorised primarily as drug omission. Pharmacy students can provide a beneficial service to the hospital and contribute to improved patient safety by assisting pharmacists with medication reconciliation.
