Medication reconciliation by a pharmacy technician  in a mental health assessment unit.
BACKGROUND
Medication discrepancies are common when patients cross organisational boundaries. However, little is known about the frequency of discrepancies within mental health and the efficacy of interventions to reduce discrepancies.


OBJECTIVE
To evaluate the impact of a pharmacy-led reconciliation service on medication discrepancies on admissions to a secondary care mental health trust.


METHODS
In-patient mental health services.


METHODS
Prospective evaluation of pharmacy technician led medication reconciliation for admissions to a UK Mental Health NHS Trust. From March to June 2012 information on any unintentional discrepancies (dose, frequency and name of medication); patient demographics;and type and cause of the discrepancy was collected. The potential for harm was assessed based on two scenarios; the discrepancy was continued into primary care, and the discrepancy was corrected during admission. Logistic regression identified factors associated with discrepancies.


METHODS
Mean number of discrepancies per admission corrected by the pharmacy technician.


RESULTS
Unintentional medication discrepancies occurred in 212 of 377 admissions (56.2 %). Discrepancies involving 569 medicines (mean 1.5 medicines per admission) were corrected.The most common discrepancy was omission(n = 464). Severity was assessed for 114 discrepancies. If the discrepancy was corrected within 16 days the potential harm was minor in 71 (62.3 %) cases and moderate in 43(37.7 %) cases whereas if the discrepancy was not corrected the potential harm was minor in 27 (23.7 %) cases and moderate in 87 (76.3 %) cases. Discrepancies were associated with both age and number of medications; the stronger association was age.


CONCLUSIONS
Medication discrepancies are common within mental health services with potentially significant consequences for patients.Trained pharmacy technicians are able to reduce the frequency of discrepancies, improving safety.
Kay
K
Brownlie
Carl
C
Schneider
Roger
R
Culliford
Chris
C
Fox
Alexis
A
Boukouvalas
Cathy
C
Willan
Ian D
ID
Maidment
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000453:epidemiology; D003704:Dementia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D059065:Medication Reconciliation; D008603:Mental Health; D008875:Middle Aged; D010596:Pharmacy Technicians; D019338:Polypharmacy; D012044:Regression Analysis