title: What errors can be identified by Pharmacy-led medicines reconciliation? A prospective study.
abstract: OBJECTIVE
  To establish the nature and frequency of discrepancies identified by pharmacy staff during medicines reconciliation.(MR) METHODS: Pharmacy staff collected data prospectively from 161 patients over a 1 week period, including information on any prescription errors identified.
  
  
  RESULTS
  In total, 62 patients (48%) taking one or more medications prior to admission to hospital had one or more discrepancies found by pharmacy staff during MR. The most common discrepancy was omission of one or more drugs.
  
  
  CONCLUSIONS
  Pharmacy staff identified several unintentional discrepancies in prescribing of medications at admission to hospital. Doctors should ensure that intentional changes to patient prescriptions are clearly documented.
authors.affiliation: Lead Clinical Pharmacist (Admissions), Pharmacy Department, Mid Essex Hospitals NHS Trust, Court Road, Broomfield, Essex, CM1 7ET. maria.richards@meht.nhs.uk
authors.forename: Maria
authors.initials: M
authors.lastname: Richards
authors.forename: Diane
authors.initials: D
authors.lastname: Ashiru-Oredope
authors.forename: Nigel
authors.initials: N
authors.lastname: Chee
mesh_terms: D000328:Adult; D003625:Data Collection; D006801:Humans; D008499:Medical Records; D008508:Medication Errors / Q000706:statistics & numerical data*; D010607:Pharmacy Service, Hospital / Q000592:standards*; D011446:Prospective Studies