ArticleBMJ open2019
Prevalence, clinical relevance and predictive factors of medication discrepancies revealed by medication reconciliation at hospital admission: prospective study in a Swiss internal medicine ward.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 50 citations in OpenAlex.
- Trial
- Sources of medication omissions among hospitalized older adults with polypharmacy.Journal of the American Geriatrics Society · 2022Trial
- Effect of Medication Reconciliation at Hospital Admission on 30-Day Returns to Hospital: A Randomized Clinical Trial.JAMA network open · 2021Trial
- Medication discrepancies and medication-related problems in psychiatric patients: A medication reconciliation study.Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences · 2026Article
- Evaluating the quality, feasibility and patient satisfaction of medication history taking by telephone for patients with scheduled admissions: a pilot study.International journal of clinical pharmacy · 2026Article
- Observational
- Using Medication Management Technologies in Swiss Primary Care: Mixed Methods Study.Journal of medical Internet research · 2025Article
- Impact of clinical pharmacist involvement on emergency department physicians' work-time distribution: a comparative analysis.Therapeutic advances in drug safety · 2025Article
- Medication reconciliation by pharmacists for pre-admission patients improves patient safety.Journal of pharmaceutical health care and sciences · 2024Article
- Proposal for a new study design and endpoint in research on medication history taking.Journal of pharmaceutical policy and practice · 2024Article
- Effectiveness of Clinical Pharmacists-Led Medication Reconciliation to Prevent Medication Discrepancies in Hospitalized Patients: A Non-Randomized Controlled Trial.Integrated pharmacy research & practice · 2024Article
- The impact of clinical pharmacists' medication reconciliation upon patients' admission to reduce medication discrepancies in the emergency department: a prospective quasi-interventional study.International journal of emergency medicine · 2023Article
- The impact of pharmacist-led medication reconciliation and interprofessional ward rounds on drug-related problems at hospital discharge.International journal of clinical pharmacy · 2023Article
- Unintended medication discrepancies and associated factors upon patient admission to the internal medicine wards: identified through medication reconciliation.BMC health services research · 2022Article
- Development and validation of a ready-to-use score to prioritise medication reconciliation at patient admission in an orthopaedic and trauma department.European journal of hospital pharmacy : science and practice · 2022Article
- The value of incorporating patient-consulted medication reconciliation in influencing drug-related actions in the outpatient rheumatology setting.BMC health services research · 2022Observational
- Usability and perceived usefulness of patient-centered medication reconciliation using a personalized health record: a multicenter cross-sectional study.BMC health services research · 2022Article
- Risk factors for clinically relevant deviations in patients' medication lists reported by patients in personal health records: a prospective cohort study in a hospital setting.International journal of clinical pharmacy · 2022Article
- Unintentional Medication Discrepancies at Admission Among Elderly Inpatients with Chronic Medical Conditions in Vietnam: A Single-Centre Observational Study.Drugs - real world outcomes · 2022Article
- Medication discrepancies among hospitalized patients with hypertension: assessment of prevalence and risk factors.BMC health services research · 2021Observational
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveMedication reconciliation (MedRec) is a relevant safety procedure in medication management at transitions of care. The aim of this study was to evaluate the impact of MedRec, including a
designProspective interventional study. Data were analysed using descriptive statistics followed by univariate and multivariate Poisson regression models and a zero-inflated Poisson regression model.
settingInternal medicine ward in a secondary care hospital in Southern Switzerland.
participantsThe first 100 consecutive patients admitted in an internal medicine ward. PRIMARY AND SECONDARY OUTCOME MEASURES: Medication discrepancies between the medication list obtained by the physician and that obtained by a pharmacist according to a systematic approach (BPMH) were collected, quantified and assessed by an expert panel that assigned a severity score. The same procedure was applied to discrepancies regarding allergies. Predicting factors for medication discrepancies were identified.
resultsThe median of medications per patient was 8 after standard medication history and 11 after BPMH. Total admission discrepancies were 524 (5.24 discrepancies per patient) with at least 1 discrepancy per patient. For 47 patients, at least one discrepancy was classified as clinically relevant. Discrepancies were classified as significant and serious in 19% and 2% of cases, respectively. Furthermore, 67% of the discrepancies were detected during the interview conducted by the pharmacist with the patients and/or their caregivers. The number of drugs used and the autonomous management of home therapy were associated with an increased number of clinically relevant discrepancies in a multivariable Poisson regression model.
conclusionEven in an advanced healthcare system, a standardised MedRec process including a BPMH represents an important strategy that may contribute to avoid a notable number of clinically relevant discrepancies and potential adverse drug events.
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