Clinical impact of medication reconciliation on physicians' treatment policies at outpatient clinics: a cross-sectional study.
Guidelines recommend implementing medication reconciliation (MR) at every healthcare transition. However, limited research has been conducted in outpatient clinics to explore whether MR affects the physicians' decisions. This study aims to evaluate the clinical impact of MR in these settings, specifically investigating whether MR leads to adjustments in treatment policies. The study also aims to assess the severity of potential harm avoided by these adjustments.
A cross-sectional study was performed between 1 June 2019 to 18 April 2022 at Maastricht University Medical Center+, The Netherlands, involving 20 different outpatient clinics. All patients who had an appointment at one of the involved clinics were assessed for eligibility (n = 3,031). Pharmacy technicians obtained the best possible medication history (BPMH) through MR. The BPMH was shared with the physician after the patient's visit. The physician could adjust his initial treatment policy based on the new information provided with the BPMH. The physician scored the severity of these policy adjustments, using the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) index.
The primary outcome was the proportion of patients with a policy adjustment. Secondary outcomes included the proportion of patients with potential severe harm and the physician's perceived value of the BMPH for possible future treatment. Descriptive data analysis was used.
In total, 2,289 patients were included (mean age: 59, 47.6% male). MR in outpatient clinics resulted in treatment policy adjustments by physicians in 3.8% of patients, with physicians deeming 0.5% of all MRs necessary to prevent severe harm. Physicians considered the BPMH valuable for future treatment in 13.8% of patients.
Routine medication reconciliation for all patients at every outpatient visit is not justified by this study. Future research should focus on identifying high-risk patient who would benefit most from MR in outpatient clinics.
A cross-sectional study was performed between 1 June 2019 to 18 April 2022 at Maastricht University Medical Center+, The Netherlands, involving 20 different outpatient clinics. All patients who had an appointment at one of the involved clinics were assessed for eligibility (n = 3,031). Pharmacy technicians obtained the best possible medication history (BPMH) through MR. The BPMH was shared with the physician after the patient's visit. The physician could adjust his initial treatment policy based on the new information provided with the BPMH. The physician scored the severity of these policy adjustments, using the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) index.
The primary outcome was the proportion of patients with a policy adjustment. Secondary outcomes included the proportion of patients with potential severe harm and the physician's perceived value of the BMPH for possible future treatment. Descriptive data analysis was used.
In total, 2,289 patients were included (mean age: 59, 47.6% male). MR in outpatient clinics resulted in treatment policy adjustments by physicians in 3.8% of patients, with physicians deeming 0.5% of all MRs necessary to prevent severe harm. Physicians considered the BPMH valuable for future treatment in 13.8% of patients.
Routine medication reconciliation for all patients at every outpatient visit is not justified by this study. Future research should focus on identifying high-risk patient who would benefit most from MR in outpatient clinics.
Authors
Hilhorst Hilhorst, Bruninx Bruninx, Bermejo Bermejo, Gonzalvo Gonzalvo, Magdelijns Magdelijns, Faber Faber, Karapinar-Carkit Karapinar-Carkit
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