Pharmacy student-assisted medication reconciliation: Number and types of medication discrepancies identified by pharmacy students

Louise Deep, Carl R. Schneider, Rebekah Moles, Asad E. Patanwala, Linda L. Do, Rosemary Burke, Jonathan Penm

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Medication reconciliation aims to prevent unintentional medication discrepancies that can result in patient harm at transitions of care. Pharmacist-led medication reconciliation has clear benefits, however workforce limitations can be a barrier to providing this service. Pharmacy students are a potential workforce solution. Objective: To evaluate the number and type of medication discrepancies identified by pharmacy students. Methods: Fourth year pharmacy students completed best possible medication histories and identified discrepancies with prescribed medications for patients admitted to hospital. A retrospective audit was conducted to determine the number and type of medication discrepancies identified by pharmacy students, types of patients and medicines involved in discrepancies. Results: There were 294 patients included in the study. Overall, 72% (n=212/294) had medication discrepancies, the most common type being drug omission. A total of 645 discrepancies were identified, which was a median of three per patient. Patients with discrepancies were older than patients without discrepancies with a median (IQR) age of 74 (65-84) vs 68 (53-77) years (p=0.001). They also took more medicines with a median (IQR) number of 9 (6-3) vs 7 (2-10) medicines per patient (p<0.001). The most common types of medicines involved were those related to the alimentary tract and cardiovascular system. Conclusions: Pharmacy students identified medication discrepancies in over 70% of hospital inpatients, categorised primarily as drug omission. Pharmacy students can provide a beneficial service to the hospital and contribute to improved patient safety by assisting pharmacists with medication reconciliation.

Original languageEnglish (US)
Article number2471
JournalPharmacy Practice
Volume19
Issue number3
DOIs
StatePublished - Jul 1 2021

Keywords

  • Australia
  • Cross-sectional studies
  • Hospitalization
  • Medical history taking
  • Medication reconciliation
  • Pharmaceutical services
  • Pharmacists
  • Professional competence
  • Students, pharmacy
  • Workforce

ASJC Scopus subject areas

  • Pharmacy
  • Pharmaceutical Science

Fingerprint

Dive into the research topics of 'Pharmacy student-assisted medication reconciliation: Number and types of medication discrepancies identified by pharmacy students'. Together they form a unique fingerprint.

Cite this