RT Journal
A1 Mueller SK, Sponsler K, Kripalani S, Schnipper JL
T1 Hospital-based medication reconciliation practices: A systematic review
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2012
FD July 23
VO 172
IS 14
SP 1057
OP 1069
DO 10.1001/archinternmed.2012.2246
UL http://dx.doi.org/10.1001/archinternmed.2012.2246
AB Background 
                  Medication discrepancies at care transitions are common and lead to patient harm. Medication reconciliation is a strategy to reduce this risk.Objectives 
                  To summarize available evidence on medication reconciliation interventions in the hospital setting and to identify the most effective practices.Data Sources 
                  MEDLINE (1966 through February 2012) and a manual search of article bibliographies.Study Selection 
                  Twenty-six controlled studies.Data Extraction 
                  Data were extracted on study design, setting, participants, inclusion/exclusion criteria, intervention components, timing, comparison group, outcome measures, and results.Data Synthesis 
                  Studies were grouped by type of medication reconciliation intervention—pharmacist related, information technology (IT), or other—and were assigned quality ratings using US Preventive Services Task Force criteria.Results 
                  Fifteen of 26 studies reported pharmacist-related interventions, 6 evaluated IT interventions, and 5 studied other interventions. Six studies were classified as good quality. The comparison group for all the studies was usual care; no studies compared different types of interventions. Studies consistently demonstrated a reduction in medication discrepancies (17 of 17 studies), potential adverse drug events (5 of 6 studies), and adverse drug events (2 of 2 studies) but showed an inconsistent reduction in postdischarge health care utilization (improvement in 2 of 8 studies). Key aspects of successful interventions included intensive pharmacy staff involvement and targeting the intervention to a high-risk patient population.Conclusions 
                  Rigorously designed studies comparing different inpatient medication reconciliation practices and their effects on clinical outcomes are scarce. Available evidence supports medication reconciliation interventions that heavily use pharmacy staff and focus on patients at high risk for adverse events. Higher-quality studies are needed to determine the most effective approaches to inpatient medication reconciliation.