title: Medication reconciliation is a prerequisite for obtaining a valid medication review.
abstract: BACKGROUND
  The objective of this study was to compare medication reconciliation and medication review based on number, type and severity of discrepancies and drug-related problems (DRPs), denoted errors.
  
  
  METHODS
  This was a retrospective study conducted at the Department of Cardiology, Hillerød Hospital. Medication reconciliation compared the prescriptions in patient records, an electronic medication system (EMS) and in discharge summaries (DS). The medication review was based on the EMS. The two methods were performed on the same data material. To assess the clinical importance of the errors, a four-point scale was applied.
  
  
  RESULTS
  A total of 75 patient records were included. In all, 198 discrepancies were identified by medication reconciliation, 2.6 per patient. The most frequent discrepancies were omission of a drug in the DS and discrepancy between the drugs noted in the patient record and the EMS. 15% of the discrepancies were potentially serious or fatal, 62% were potentially significant and 23% were potentially non-significant. A total of 129 DRPs were identified by medication review, 1.7 per patient. The most frequent DRPs were sub therapeutic dosage, inappropriate dosage regimen and untreated medical condition. 35% of the DRPs were potentially serious or fatal, 29% were potentially significant and 36% were potentially non-significant.
  
  
  CONCLUSIONS
  Medication reconciliation identified a higher number of errors than medication review, but the number of serious errors identified by medication review was higher than that identified by medication reconciliation. The two methods identified different types of errors and should be used concurrently to supplement each other.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors: Pharmacy of the Capital Region, Hillerød Hospital, Hillerød, Denmark.
authors: Mette
authors: M
authors: Bjeldbak-Olesen
authors: Anja Gadsbølle
authors: AG
authors: Danielsen
authors: Dorthe Vilstrup
authors: DV
authors: Tomsen
authors: Tomas Joen
authors: TJ
authors: Jakobsen
mesh_terms: D000368:Aged; D011307:Drug Prescriptions / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized / Q000592:standards*; D008508:Medication Errors / Q000706:statistics & numerical data*; D059065:Medication Reconciliation; D008875:Middle Aged; D063886:Patient Discharge Summaries / Q000592:standards*; D055553:Prescription Drugs / Q000008:administration & dosage; D012189:Retrospective Studies
chemical_list: D055553:Prescription Drugs