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Medication Reconciliation in Hospice: A Pilot StudyMethodist University Hospital, Memphis, Tennessee, kempl{at}methodisthealth.org
and Johns Hopkins Bayview Hospital, Baltimore, Maryland
University of Maryland
University of Maryland School of Pharmacy Baltimore, Maryland Background: The Joint Commission required implementation of medication reconciliation processes by January 2006. Medication reconciliation is the practice of acquiring an accurate medication history at each transitional point of care. Potential for errors increases with inaccurate medication histories. This study determined the extent of medication reconciliation errors in hospice. Methods: Patients were enrolled from 2 hospices in Maryland (January 2007). An initial medication history was completed by the nurse on hospice admission. The pharmacist did another medication history within 5 days of admission and compared the medication histories. All differences were reported as medication discrepancies. Results: There were 504 medication discrepancies. Medication omissions occurred most commonly. All patients had at least 1 medication discrepancy (average 8.7 per patient). Overall, 190 drug interactions were identified; most were moderately severe. Conclusion: Terminal patients often use numerous medications increasing the risk of medication errors. Accurate medication histories reduce errors and potential for harm.
Key Words: medication reconciliation • medication history • Joint Commission National Patient Safety Goal 8 • home hospice • medication error potential • medication discrepancies
This version was published on June
1, 2009 American Journal of Hospice and Palliative Medicine®, Vol. 26, No. 3,
193-199 (2009) |
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