Differences in medication reconciliation interventions between six hospitals: a mixed method study
Abstract Background Although medication reconciliation (MedRec) is mandated and effective in decreasing preventable medication errors during transition of care, hospitals implement MedRec differently. Objective Quantitatively compare the number and type of MedRec interventions between hospitals upon...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-022-08118-8 |
| _version_ | 1828811348027375616 |
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| author | C. C. M. Stuijt B. J. F. van den Bemt V. E. Boerlage M. J. A. Janssen K. Taxis F. Karapinar-Çarkit |
| author_facet | C. C. M. Stuijt B. J. F. van den Bemt V. E. Boerlage M. J. A. Janssen K. Taxis F. Karapinar-Çarkit |
| author_sort | C. C. M. Stuijt |
| collection | DOAJ |
| description | Abstract Background Although medication reconciliation (MedRec) is mandated and effective in decreasing preventable medication errors during transition of care, hospitals implement MedRec differently. Objective Quantitatively compare the number and type of MedRec interventions between hospitals upon admission and discharge, followed by a qualitative analysis on potential reasons for differences. Methods This explanatory retrospective mixed-method study consisted of a quantitative and a qualitative part. Patients from six hospitals and six different wards i.e. orthopaedics, surgery, pulmonary diseases, internal medicine, cardiology and gastroenterology were included. At these wards, MedRec was implemented both on hospital admission and discharge. The number of pharmacy interventions was collected and classified in two subcategories. First, the number of interventions to resolve unintended discrepancies (elimination of differences between listed medication and the patient’s actual medication use). And second, the number of medication optimizations (optimization of pharmacotherapy e.g. eliminating double medication). Based on these quantitative results and interviews, a focus group was performed to give insight in local MedRec processes to address differences in context between hospitals. Descriptive analysis (quantitative) and content analysis (qualitative) was used. Results On admission 765 (85%) patients from six hospitals, received MedRec by trained nurses, pharmacy technicians, pharmaceutical consultants or pharmacists. Of those, 36–95% (mean per patient 2.2 (SD ± 2.4)) had at least one discrepancy. Upon discharge, these numbers were among 632 (70%) of patients, 5–28% (mean per patient 0.7 (SD 1.2)). Optimizations in pharmacotherapy were implemented for 2% (0.4–3.7 interventions per patient upon admission) to 95% (0.1–1.7 interventions per patient upon discharge) of patients. The main themes explaining differences in numbers of interventions were patient-mix, the type of healthcare professionals involved, where and when patient interviews for MedRec were performed and finally, embedding and extent of medication optimization. Conclusions Hospitals differed greatly in the number of interventions performed during MedRec. Differences in execution of MedRec and local context determines the number of interventions. This study can support hospitals who want to optimize MedRec processes. |
| first_indexed | 2024-12-12T09:26:24Z |
| format | Article |
| id | doaj.art-3339703068984d299f323e7d74e763b3 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-12T09:26:24Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-3339703068984d299f323e7d74e763b32022-12-22T00:29:01ZengBMCBMC Health Services Research1472-69632022-05-0122111210.1186/s12913-022-08118-8Differences in medication reconciliation interventions between six hospitals: a mixed method studyC. C. M. Stuijt0B. J. F. van den Bemt1V. E. Boerlage2M. J. A. Janssen3K. Taxis4F. Karapinar-Çarkit5ApoMedDepartment of Pharmacy, Sint MaartenskliniekDepartment of Pharmacotherapy and Pharmaceutical Care, University of GroningenDepartment of Clinical Pharmacy, OLVGDepartment of Pharmacotherapy and Pharmaceutical Care, University of GroningenDepartment of Clinical Pharmacy, OLVGAbstract Background Although medication reconciliation (MedRec) is mandated and effective in decreasing preventable medication errors during transition of care, hospitals implement MedRec differently. Objective Quantitatively compare the number and type of MedRec interventions between hospitals upon admission and discharge, followed by a qualitative analysis on potential reasons for differences. Methods This explanatory retrospective mixed-method study consisted of a quantitative and a qualitative part. Patients from six hospitals and six different wards i.e. orthopaedics, surgery, pulmonary diseases, internal medicine, cardiology and gastroenterology were included. At these wards, MedRec was implemented both on hospital admission and discharge. The number of pharmacy interventions was collected and classified in two subcategories. First, the number of interventions to resolve unintended discrepancies (elimination of differences between listed medication and the patient’s actual medication use). And second, the number of medication optimizations (optimization of pharmacotherapy e.g. eliminating double medication). Based on these quantitative results and interviews, a focus group was performed to give insight in local MedRec processes to address differences in context between hospitals. Descriptive analysis (quantitative) and content analysis (qualitative) was used. Results On admission 765 (85%) patients from six hospitals, received MedRec by trained nurses, pharmacy technicians, pharmaceutical consultants or pharmacists. Of those, 36–95% (mean per patient 2.2 (SD ± 2.4)) had at least one discrepancy. Upon discharge, these numbers were among 632 (70%) of patients, 5–28% (mean per patient 0.7 (SD 1.2)). Optimizations in pharmacotherapy were implemented for 2% (0.4–3.7 interventions per patient upon admission) to 95% (0.1–1.7 interventions per patient upon discharge) of patients. The main themes explaining differences in numbers of interventions were patient-mix, the type of healthcare professionals involved, where and when patient interviews for MedRec were performed and finally, embedding and extent of medication optimization. Conclusions Hospitals differed greatly in the number of interventions performed during MedRec. Differences in execution of MedRec and local context determines the number of interventions. This study can support hospitals who want to optimize MedRec processes.https://doi.org/10.1186/s12913-022-08118-8Medication reconciliationMedication errorsHospital admissionHospital dischargeHospital pharmacy |
| spellingShingle | C. C. M. Stuijt B. J. F. van den Bemt V. E. Boerlage M. J. A. Janssen K. Taxis F. Karapinar-Çarkit Differences in medication reconciliation interventions between six hospitals: a mixed method study BMC Health Services Research Medication reconciliation Medication errors Hospital admission Hospital discharge Hospital pharmacy |
| title | Differences in medication reconciliation interventions between six hospitals: a mixed method study |
| title_full | Differences in medication reconciliation interventions between six hospitals: a mixed method study |
| title_fullStr | Differences in medication reconciliation interventions between six hospitals: a mixed method study |
| title_full_unstemmed | Differences in medication reconciliation interventions between six hospitals: a mixed method study |
| title_short | Differences in medication reconciliation interventions between six hospitals: a mixed method study |
| title_sort | differences in medication reconciliation interventions between six hospitals a mixed method study |
| topic | Medication reconciliation Medication errors Hospital admission Hospital discharge Hospital pharmacy |
| url | https://doi.org/10.1186/s12913-022-08118-8 |
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