Improving medication reconciliation in the outpatient setting.
BACKGROUND
A systematic study into outpatient medication reconciliation was conducted to determine if a multifaceted intervention influencing providers and patients reduced discrepancies related to inadequate prescription medication reconciliation in an outpatient setting.


METHODS
A prospective trial was conducted on 104 primary care patients at the Mayo Clinic. Patients in Phase I received standard care. Patients in Phase II received the intervention reconciliation process, which consisted of (1) mailed letters before appointments to remind patients to bring medication bottles or updated medication lists to their visits, (2) verification, and (3) correction of the medication list in the electronic medical record by the patient, and academic detailing and weekly audit and feedback of performance.


RESULTS
Interventions resulted in a decrease in prescription medication errors from 88.9% of the visits in Phase 1 to 66% of the visits in Phase II (p = .005) and from 98.2% of the visits in Phase I to 84% of the visits in Phase II (p = .0134) when all medications were considered. The average number of discrepancies per patient decreased by more than 50% from 5.24 in Phase I to 2.46 in Phase II. The majority of discrepancies were minor.


CONCLUSIONS
A multifaceted intervention including various members of the health care provider team (and the patient) is crucial to enhancing medication reconciliation.
Varkey
Prathibha
P
Division of Preventive and Occupational Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA. Varkey.prathibha@mayo.edu
Cunningham
Julie
J
Bisping
D Susan
DS
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000554:Ambulatory Care Facilities / Q000592:standards; D017723:Drug Utilization Review; D006123:Group Practice / Q000592:standards; D008508:Medication Errors / Q000517:prevention & control / Q000706:statistics & numerical data; D008910:Minnesota; D010349:Patient Compliance; D010353:Patient Education as Topic; D010865:Pilot Projects; D011320:Primary Health Care / Q000592:standards; D015397:Program Evaluation; D011446:Prospective Studies; D017010:Reminder Systems; D017749:Total Quality Management