The impact of a medication reconciliation program at geriatric hospital admission: a pre/post intervention study.
Br J Clin Pharmacol. 2019 Aug 16;:
Authors: Hung PL, Chen JY, Chen MT, Li PL, Li WC, Wang ZC, Huang TT, Liang YT, Lin PC
AIMS: The aim of this study was to improve medication reconciliation and reduce the occurrence of duplicate prescriptions by pharmacists and physicians within 72 hours of hospital admission using an intelligent prescription system combined with the National PharmaCloud system to integrate the database with the medical institution Computerized Physician Order Entry (CPOE) system.
METHODS: This two-year intervention study was implemented in the geriatric ward of a hospital in Taiwan. We developed an integrated CPOE system linked with the PharmaCloud database and established an electronic platform for coordinated communication with all healthcare professionals. Patients provided written informed consent to access their National Health Insurance (NHI) PharmaCloud records. We compared the intervention effectiveness within 72 hours of admission for improvement in pharmacist medication reconciliation, increased at-home medications documentation, and decreased costs from duplicated at-home prescriptions.
RESULTS: The medication reconciliation rate within 72 hours of admission increased from 44.0% pre-intervention to 86.8% post-intervention (RR=1.97, 95% CI: 1.69, 2.31; p < 0.001). The monthly average of patients who brought and took home medications documented in the CPOE system during hospitalization increased by 7.54 (95% CI 5.58, 20.49 p = 0.22). The monthly average of home medications documented increased by 102.52 (95% CI 38.44, 166.60; p =0.01). Savings on the monthly average prescription expenditures of at-home medication increased by US$ 2,795.52 (95% CI US$1,310.41, US$4,280.63; p < 0.01).
CONCLUSIONS: Integrating medication data from the NHI PharmaCloud to the hospital's medical chart system improved pharmacist medication reconciliation, which decreased duplicated medications and reduced in-hospital medication costs.
PMID: 31418902 [PubMed - as supplied by publisher]