Development of Medication Reconciliation Process for Inpatients

Abstract

Objective: To explore the problems of medication reconciliation (MR)process for inpatients in Nopparat Ratchathani hospital and determine costsaving from using the patient’s home medications during admission.Method: From January to June, 2010, all patients admitted in theorthopedic wards were enrolled in the study. Data were collected from MRform, medical records, and the patient’s home medications. Of 160 patientsadmitted, 151 with adequate medication history were included in analysis.Most patients were female (99 patients), with an average age of 67.2 yearsand hypertension as co-morbidity. The MR forms were fully completed inonly 18 patients (11.9%). The most frequently missing information was thedoctor signature (80.1%). Treatment based on home medications was fullycontinued in 119 patients (78.80%), with discontinuation of somemedications in 31 patients (20.53%). Two types of drug-related problemswere found including medication errors (7.93%) and receiving the sameclass of antihypertensive drugs (3.3%). A record of home medications fordischarge was not placed in the outpatient file in 12 patients (74.2%). Costsaving from using home medications was 42,766.23 baht. Conclusion:Medication reconciliation processes facilitate identifying drug-relatedproblem, decreasing prescribing medication errors, and cost-saving.However some measures could improve the process, for example, a fulltimepharmacist in each ward, and the patient’s medication record booklet.Keywords: medication reconciliation, medication error, prescribing