The reconciliation process consisted of comparing the patient's medications listed in the admission orders to the medication information documented in: 1) the physician's history and physical; 2) the patient's admission profile, a form completed collaboratively by the nurse and patient (or patient's advocate); and 3) information obtained during the pharmacist-conducted interview. A discrepancy was defined as any inconsistency or difference in the medication regimen noted during this manual comparison process.
The study found that pharmacists are in the best position to perform medication reconciliation.
"We believe that pharmacists are especially suited to obtain medication histories and perform reconciliation based on their education, experience, medication knowledge and patient counseling skills," says Gleason. "Pharmacists can recognize sound-alike and look-alike medications or omissions that others may miss, or dosages that don't seem right."
"The project clearly demonstrated that pharmacists play an integral role in this," adds Gary Noskin, M.D., a study author, the medical director of Healthcare Epidemiology and Quality at Northwestern Memorial and professor at Northwestern's Feinberg School of Medicine. "And what this paper demonstrates is that medication reconciliation is an effective method to prevent medicati
Contact: Andrew Buchanan
Northwestern Memorial Hospital