A CRITICAL APPRAISAL OF CURRENT PRACTICES, IMPLEMENTATION STRATEGIES, AND CLINICAL OUTCOMES

Abstract

Medication reconciliation [MR] is an essential safety process where a patient's active medication list is compared with that prescribed newly with each care transition MR serves as an important safety tool to ensure accurate and up-to-date medication records thereby minimizing medication errors adverse drug events and unnecessary duplication during care transitions Despite its importance MR has not yet been implemented systematically and consistently throughout all areas of health care and consequently avoidable patient harm has occurred which in turn leads to high costs. This review synthesizes the current state of practice around MR, challenges encountered with its implementation, facilitators that enhance adoption, and clinical outcome results. We undertook an exhaustive review of all available peer-reviewed published reports for medication reconciliation intervention, IT supported intervention, and multidisciplinary approaches. The result suggests that systematically reconciled medication lists aided by hospital health care information systems and teamwork of multidisciplinary team result in significantly lower number of medication discrepancies and adverse events. Nevertheless, several challenges of resources and operational constraints such as inefficient clinical workflow and limited physician compliance make it difficult to reconcile medication in all the scenarios. The article proposes standardization of medication reconciliation in form of evidence-based procedures as well as utilizing innovation technology and committing organization is imperative for improving patient safety and medical outcomes.