Medication Reconciliation Review Finds Fewer Discrepancies and Readmissions

A mixed-methods systematic review of 70 studies evaluated medication reconciliation interventions against usual care. Meta-analysis found reductions in medication discrepancies, adverse drug events, readmissions and emergency department visits; pharmacist-led interventions and reconciliation at hospital admission were highlighted.

Review included 70 studies of medication reconciliation.
Pooled analysis found fewer discrepancies and adverse drug events.
Readmissions and emergency visits were also reduced.
Pharmacist-led and admission-based approaches were highlighted.

Medication reconciliation is used to identify and resolve medication discrepancies during transitions of care, but the contribution of specific implementation strategies has been uncertain. This mixed-methods systematic review searched PubMed, Web of Science and Embase for studies published from January 2000 to May 2024. Of 7,209 records screened, 70 studies comparing medication reconciliation with usual care were included. The review identified 20 distinct components of medication reconciliation protocols and pooled quantitative outcomes using random-effects meta-analysis.

Medication reconciliation was associated with fewer medication discrepancies (RR 0.39, 95% CI 0.28–0.53), adverse drug events or reactions (RR 0.61, 95% CI 0.47–0.79), 30-day all-cause readmissions (RR 0.73, 95% CI 0.68–0.78), emergency department visits (RR 0.60, 95% CI 0.52–0.68) and drug-related readmissions (RR 0.51, 95% CI 0.31–0.84). Subgroup analyses identified pharmacist-led interventions and medication reconciliation at hospital admission as particularly effective; admission reconciliation had the highest reported effective ratio (9.40).

The findings support medication reconciliation as a potentially useful patient-safety strategy at care transitions. However, the review covers varied interventions and settings, and the abstract does not provide further detail on study quality or the comparability of included protocols. The results identify promising components but do not establish a single optimal protocol.

In practice

For clinicians involved in hospital care transitions, this review supports medication reconciliation as a strategy associated with fewer medication discrepancies, adverse drug events, readmissions and emergency department visits. The subgroup findings point to pharmacist-led reconciliation and reconciliation at hospital admission as potentially effective approaches. These results do not establish one optimal protocol: the 70 included studies described varied intervention components, and the supplied report does not provide details on study quality or the consistency of effects across settings. The findings support implementation consideration, not a specific mandated workflow.

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Source

Journal of General Internal Medicine: Improving Patient Safety Through Medication Reconciliation at Care Transitions: A Mixed Methods Systematic Review ↗

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