Evidence map›Paper›PMID 38569666›Full record

ArticleBMJ open quality2024

Journey of medication reconciliation compliance in a lower middle-income country: a retrospective chart review.

Samar Fatima, Ainan Arshad, Amara Zafar, Sana Farrukh, Anum Rahim, Saharish Nazar, Hasnain Zafar

Open access · goldAbstract read
In one paragraph

Article in BMJ open quality, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.4field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Samar Fatima *Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan.ORCID 0000-0002-4617-129X
Ainan Arshad *Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan ainan.arshad@aku.edu.ORCID 0000-0002-9013-3899
Amara Zafar *Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan.
Sana Farrukh *Department of Community Health Sciences, The Aga Khan University Hospital, Karachi, Pakistan.
Anum Rahim *Department of Community Health Sciences, The Aga Khan University Hospital, Karachi, Pakistan.
Saharish Nazar *Pharmacy, The Aga Khan University Hospital, Karachi, Pakistan.
Hasnain Zafar *Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan.
Aga Khan University Hospital · PK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThere were three main objectives of the study: to determine the overall compliance of medication reconciliation over 4 years in a tertiary care hospital, to compare the medication reconciliation compliance between paper entry (initial assessment forms) and computerised physician order entry (CPOE), and to identify the discrepancies between the medication history taken by the physician at the time of admission and those collected by the pharmacist within 24 hours of admission.

methodsThis study was conducted at a tertiary care hospital in a lower middle-income country. Data were gathered from two different sources. The first source involved retrospective data obtained from the Quality and Patient Safety Department (QPSD) of the hospital, consisting of records from 8776 patients between 2018 and 2021. The second data source was also retrospective from a quality project initiated by pharmacists at the hospital. Pharmacists collected data from 1105 patients between 2020 and 2021, specifically focusing on medication history and identifying any discrepancies compared with the history documented by physicians. The collected data were then analysed using SPSS V.26.

resultsThe QPSD noted an improvement in physician-led medication reconciliation, with a rise from 32.7% in 2018 to 69.4% in 2021 in CPOE. However, pharmacist-led medication reconciliation identified a 25.4% (n=281/1105) overall discrepancy in the medication history of patients admitted from 2020 to 2021, mainly due to incomplete medication records in the initial assessment forms and CPOE. Physicians missed critical drugs in 4.9% of records; pharmacists identified and updated them.

conclusionIn a lower middle-income nation where hiring pharmacists to conduct medication reconciliation would be an additional cost burden for hospitals, encouraging physicians to record medication history more precisely would be a more workable method. However, in situations where cost is not an issue, it is recommended to adopt evidence-based practices, such as integrating clinical pharmacists to lead medication reconciliation, which is the gold standard worldwide.

Indexed as

Medication ReconciliationPatient AdmissionHospitalizationHumansPatient SafetyRetrospective StudiesEvidence-Based PracticeHealthcare quality improvementMedication reconciliation

Identifiers

PMID38569666
PMCPMC10989168
OpenAlexW4393868132

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.