The DOI matches its Crossref record; 45 of the 45 references it cites were found in a registry or an index.
Pharmacy-led medication reconciliation programmes at hospital transitions: A systematic review and meta-analysis.
Open accessAbstract
WHAT IS KNOWN AND OBJECTIVE: Medication reconciliation is recognized as an important tool for the prevention of medication discrepancies and subsequent patient harm at care transitions. However, there is inconclusive evidence as to the impact of medication reconciliation at hospital transitions overall, as well as pharmacy-led medication reconciliation services. This review sought to evaluate the impact of pharmacy-led medication reconciliation interventions on medication discrepancies at hospital transitions and to categorize these interventions as single transition interventions or multiple transitions interventions. METHODS: PubMed, MEDLINE, EMBASE, IPA, CINHAL and PsycINFO databases, inclusive from inception to December 2014, were searched. Included studies were published studies in English that compared the effectiveness of pharmacy-led medication reconciliation interventions to usual care and that aimed to assess medication discrepancies at hospital transitions. 'Usual care' was defined as any care where targeted medication reconciliation was not undertaken as an intervention, or if an intervention was conducted, it was not provided by a pharmacist/pharmacy technician. RESULTS AND DISCUSSION: Nineteen studies which involved a total of 15 525 adult patients were included. Eleven studies were randomized controlled trials. Overall, pharmacy-led medication reconciliation intervention usually revealed a trend towards reduction in medication discrepancies, compared with usual care. Seventeen studies involving 18 medication reconciliation interventions targeting the various transitions (admission, 9; discharge, 4; and multiple transitions, 5) were included in the meta-analysis. Compared with usual care, single medication reconciliation interventions at transitions in care (either admission or discharge) showed a significant reduction of 66% in patients with medication discrepancies (RR 0·34; 95% CI: 0·23-0·50) in favour of the intervention. There was no difference between groups for interventions targeting multiple transitions (RR 0·88; 95% CI: 0·77-1·02). Subgroup analyses confined to RCTs showed that there were no differences for target of transition (admission vs. discharge), type of intervention (multifaceted intervention vs. medication reconciliation) and setting (single centre vs. multicentre), nor pharmacists vs. pharmacy technicians (non-RCTs only). Importantly, medication discrepancies of higher clinical impact were more easily identified through pharmacy-led interventions than with usual care. WHAT IS NEW AND CONCLUSION: Pharmacy-led medication reconciliation interventions were found to be an effective strategy to reduce medication discrepancies, and had a greater impact when conducted at either admission or discharge but were less effective during multiple transitions in care. Further studies that are designed to assess the impact of the involvement of pharmacy technicians in medication reconciliation are also needed.
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“No differential effect was observed in the a priori sepsis subgroup of 1,689 patients (508).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [508]
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“The trial, which randomized 3,000 participants, demonstrated no difference in mortality in those allocated to an accelerated strategy of RRT compared with those allocated to a “standard” strategy.”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [508]
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“Studies of tools employed to promote SDM in patients with other serious illnesses show improved patient knowledge and awareness of treatment options (595).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [595]
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“Transfer from ICU to general floor and discharge from the hospital are both vulnerable periods for patients, with high frequency of medication errors and information loss [596–602].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [598]
In the citing paper
“Medication reconciliation has been associated with fewer medication errors [598, 612] and may help reduce hospital readmission [613, 614].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [598]
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Flagged first, then by citations
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- Institute for Healthcare Improvement Medication reconciliation review http://www.ihi.org/resources/Pages/Tools/MedicationReconciliationReview.aspx
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Items 301–309 of 309
Jang, S., Lim, J., Moon, A., Lee, J., Ah, Y., Lee, H. J., Lee, S. Y., Kim, J., & Jang, S. (2026) · Drugs & Aging · doi:10.1007/s40266-026-01325-6
“Our findings regarding hospital readmission corroborate a recent meta-analysis on the impact of MR, which reported a significant reduction in the risk of readmission (RR 0.81; 95% CI 0.70–0.95) [19].”
InfluentialWickman, K., Lenander, C., Caleres, G., & Modig, S. (2026) · Pharmacy · doi:10.3390/pharmacy14050122
Sagara, H., Yamane, M., Yasuhide, K., Inamori, A., & Teshima, H. (2026) · Cureus · doi:10.7759/cureus.116074
Durowaa, I. A., Brenya, J. K., Boakye, A., Sarkodie, E., Frimpong, B., & Twum, P. (2026) · Research Square · doi:10.21203/rs.3.rs-10672688/v1
Yanamadala, P. K., Rani, P. S. U., Devarakonda, S., Sonti, L. P., Annaladasu, R. R., Thetakayala, K. S., Nadendla, R. R., & Vadlamudi, P. (2026) · SN Comprehensive Clinical Medicine · doi:10.1007/s42399-026-02730-z
“Collaborative involvement of physicians, pharmacists, nurses, and pharmacologists may support safer prescribing practices [ 14, 42].”
Transitioning to Care: Core Components and Outcomes of Transitional Care Programs for Older Adults
Panda, S. R., Shetty, A. P., & Dwibedi, B. (2026) · Ageing International · doi:10.1007/s12126-026-09679-3
“…information, inadequate discharge planning, poor communication between healthcare professionals, insufficient caregiver preparation, and limited access to appropriate follow-up can contribute to adverse events after discharge (Naylor et al., 1999; Naylor et al., 2004; Mekonnen et al., 2016 ).”
InfluentialMarkoja, U., & Kovačič, A. (2026) · Wiener klinische Wochenschrift · doi:10.1007/s00508-026-02833-6
Mitku, M. L., Anagaw, Y. K., Dagnaw, A. D., Geremew, D. T., Ferede, Y. A., Denekew, T., Worku, M. C., Limenh, L. W., Bekele, A., & Ayenew, W. A. (2026) · Health Science Reports · doi:10.1002/hsr2.73362
Da, F., Jin, Z., Jian, Z., Zhang, Y., Guo, X., Zheng, Z., Chen, S., Zhang, D., & Feng, Z. (2026) · Journal of General Internal Medicine · doi:10.1007/s11606-026-10376-9
Metadata
- Authors
- Mekonnen, A. B., McLachlan, A. J., & Brien, J.-A. E.
- Affiliations
- The University of Sydney (AU)
- Corresponding author
- Mekonnen, Alemayehu B.
- Venue
- Journal of Clinical Pharmacy and Therapeutics
- Publisher
- Wiley
- Published
- 2016-02-23
- Volume
- 41
- Issue
- 2
- Pages
- 128-144
- ISSN
- 0269-4727 (ISSN-L)
- OpenAlex
- W2274951248
- Cited by
- 309
- References
- 45
- Citations by year
- 2026: 28 · 2025: 19 · 2024: 26 · 2023: 26 · 2022: 29 · 2021: 40 · 2020: 36 · 2019: 30 · 2018: 43 · 2017: 20 · 2016: 12
- FWCI
- 3.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Pharmacy and Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Own your potential (DEAKIN) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Health Professions › Pharmacy › Pharmacy and Medical Practices
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
- Keywords
- medication reconciliation, hospital transition, medication discrepancies, pharmacist involvement, patient safety, hospitalization, hospital discharge, care transitions, medication errors, pharmacy technicians, multicomponent intervention, usual care
- MeSH terms
- Hospitals, Humans, Patient Admission, Patient Discharge, Patient Transfer, Pharmacists, Pharmacy Service, Hospital, Multicenter Studies as Topic, Randomized Controlled Trials as Topic, Medication Reconciliation
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