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

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 student...

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Bibliographic Details
Published in:Pharmacy practice : official journal of the GRIPP (Global Research Institute of Pharmacy Practice) 2021-07, Vol.19 (3), p.2471
Main Authors: Deep, Louise, Schneider, Carl R., Moles, Rebekah, Patanwala, Asad E., Do, Linda L., Burke, Rosemary, Penm, Jonathan
Format: Article
Language:English
Subjects:
Australia
Cross
cross-sectional studies
Hospitalization
Medical History Taking
Medication Reconciliation
Original Research
Pharmaceutical Services
Pharmacists
Pharmacology & Pharmacy
Pharmacy
Professional Competence
Sectional Studies
Students
students pharmacy
Workforce
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Summary: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
ISSN:1885-642X
1886-3655
1886-3655
DOI:10.18549/PharmPract.2021.3.2471