Impact of medication reconciliation and review and counselling, on adverse drug events and healthcare resource use

Amna Al-Hashar, Ibrahim Al-Zakwani, Tommy Eriksson, Alaa Sarakbi, Badriya Al-Zadjali, Saif Al Mubaihsi, Mohammed A l Za'abi

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background Adverse drug events from preventable medication errors can result in patient morbidity and mortality, and in cost to the healthcare system. Medication reconciliation can improve communication and reduce medication errors at transitions in care. Objective Evaluate the impact of medication reconciliation and counselling intervention delivered by a pharmacist for medical patients on clinical outcomes 30 days after discharge. Setting Sultan Qaboos University Hospital, Muscat, Oman. Methods A randomized controlled study comparing standard care with an intervention delivered by a pharmacist and comprising medication reconciliation on admission and discharge, a medication review, a bedside medication counselling, and a take-home medication list. Medication discrepancies during hospitalization were identified and reconciled. Clinical outcomes were evaluated by reviewing electronic health records and telephone interviews. Main outcome measures Rates of preventable adverse drug events as primary outcome and healthcare resource utilization as secondary outcome at 30 days post discharge. Results A total of 587 patients were recruited (56 ± 17 years, 57% female); 286 randomized to intervention; 301 in the standard care group. In intervention arm, 74 (26%) patients had at least one discrepancy on admission and 100 (35%) on discharge. Rates of preventable adverse drug events were significantly lower in intervention arm compared to standard care arm (9.1 vs. 16%, p = 0.009). No significant difference was found in healthcare resource use. Conclusion The implementation of an intervention comprising medication reconciliation and counselling by a pharmacist has significantly reduced the rate of preventable ADEs 30 days post discharge, compared to the standard care. The effect of the intervention on healthcare resource use was insignificant. Pharmacists should be included in decentralized, patient-centred roles. The findings should be interpreted in the context of the study’s limitations.

Original languageEnglish
Pages (from-to)1154-1164
Number of pages11
JournalInternational Journal of Clinical Pharmacy
Volume40
Issue number5
DOIs
Publication statusPublished - Oct 1 2018

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Medication Reconciliation
Drug-Related Side Effects and Adverse Reactions
Counseling
Pharmacists
Delivery of Health Care
Medication Errors
Pharmaceutical Preparations
Oman
Telephone
Electronic Health Records
Health
Primary Health Care
Hospitalization
Communication
Outcome Assessment (Health Care)
Interviews
Morbidity
Costs and Cost Analysis
Mortality
Costs

Keywords

  • Adverse drug events
  • Healthcare resource use
  • Medication counselling
  • Medication reconciliation
  • Oman
  • Pharmacist

ASJC Scopus subject areas

  • Pharmacy
  • Toxicology
  • Pharmacology
  • Pharmaceutical Science
  • Pharmacology (medical)

Cite this

Impact of medication reconciliation and review and counselling, on adverse drug events and healthcare resource use. / Al-Hashar, Amna; Al-Zakwani, Ibrahim; Eriksson, Tommy; Sarakbi, Alaa; Al-Zadjali, Badriya; Al Mubaihsi, Saif; A l Za'abi, Mohammed.

In: International Journal of Clinical Pharmacy, Vol. 40, No. 5, 01.10.2018, p. 1154-1164.

Research output: Contribution to journalArticle

Al-Hashar, Amna ; Al-Zakwani, Ibrahim ; Eriksson, Tommy ; Sarakbi, Alaa ; Al-Zadjali, Badriya ; Al Mubaihsi, Saif ; A l Za'abi, Mohammed. / Impact of medication reconciliation and review and counselling, on adverse drug events and healthcare resource use. In: International Journal of Clinical Pharmacy. 2018 ; Vol. 40, No. 5. pp. 1154-1164.
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AU - Al-Zakwani, Ibrahim

AU - Eriksson, Tommy

AU - Sarakbi, Alaa

AU - Al-Zadjali, Badriya

AU - Al Mubaihsi, Saif

AU - A l Za'abi, Mohammed

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N2 - Background Adverse drug events from preventable medication errors can result in patient morbidity and mortality, and in cost to the healthcare system. Medication reconciliation can improve communication and reduce medication errors at transitions in care. Objective Evaluate the impact of medication reconciliation and counselling intervention delivered by a pharmacist for medical patients on clinical outcomes 30 days after discharge. Setting Sultan Qaboos University Hospital, Muscat, Oman. Methods A randomized controlled study comparing standard care with an intervention delivered by a pharmacist and comprising medication reconciliation on admission and discharge, a medication review, a bedside medication counselling, and a take-home medication list. Medication discrepancies during hospitalization were identified and reconciled. Clinical outcomes were evaluated by reviewing electronic health records and telephone interviews. Main outcome measures Rates of preventable adverse drug events as primary outcome and healthcare resource utilization as secondary outcome at 30 days post discharge. Results A total of 587 patients were recruited (56 ± 17 years, 57% female); 286 randomized to intervention; 301 in the standard care group. In intervention arm, 74 (26%) patients had at least one discrepancy on admission and 100 (35%) on discharge. Rates of preventable adverse drug events were significantly lower in intervention arm compared to standard care arm (9.1 vs. 16%, p = 0.009). No significant difference was found in healthcare resource use. Conclusion The implementation of an intervention comprising medication reconciliation and counselling by a pharmacist has significantly reduced the rate of preventable ADEs 30 days post discharge, compared to the standard care. The effect of the intervention on healthcare resource use was insignificant. Pharmacists should be included in decentralized, patient-centred roles. The findings should be interpreted in the context of the study’s limitations.

AB - Background Adverse drug events from preventable medication errors can result in patient morbidity and mortality, and in cost to the healthcare system. Medication reconciliation can improve communication and reduce medication errors at transitions in care. Objective Evaluate the impact of medication reconciliation and counselling intervention delivered by a pharmacist for medical patients on clinical outcomes 30 days after discharge. Setting Sultan Qaboos University Hospital, Muscat, Oman. Methods A randomized controlled study comparing standard care with an intervention delivered by a pharmacist and comprising medication reconciliation on admission and discharge, a medication review, a bedside medication counselling, and a take-home medication list. Medication discrepancies during hospitalization were identified and reconciled. Clinical outcomes were evaluated by reviewing electronic health records and telephone interviews. Main outcome measures Rates of preventable adverse drug events as primary outcome and healthcare resource utilization as secondary outcome at 30 days post discharge. Results A total of 587 patients were recruited (56 ± 17 years, 57% female); 286 randomized to intervention; 301 in the standard care group. In intervention arm, 74 (26%) patients had at least one discrepancy on admission and 100 (35%) on discharge. Rates of preventable adverse drug events were significantly lower in intervention arm compared to standard care arm (9.1 vs. 16%, p = 0.009). No significant difference was found in healthcare resource use. Conclusion The implementation of an intervention comprising medication reconciliation and counselling by a pharmacist has significantly reduced the rate of preventable ADEs 30 days post discharge, compared to the standard care. The effect of the intervention on healthcare resource use was insignificant. Pharmacists should be included in decentralized, patient-centred roles. The findings should be interpreted in the context of the study’s limitations.

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KW - Healthcare resource use

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KW - Oman

KW - Pharmacist

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