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.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“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]
Experimental — accuracy not yet measuredIn the citing paper
“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]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000097 · Cited by 64,042
Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & the PRISMA Group* (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-4-200908180-00135 · Cited by 37,554
Developing and evaluating complex interventions: the new Medical Research Council guidance
Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., & Petticrew, M. (2008) · BMJ · doi:10.1136/bmj.a1655 · Cited by 10,995
Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1. The Cochrane Collaboration
Higgins, J., Green, S. R., & Higgins, J. (2008) · Cited by 5,544
A Reengineered Hospital Discharge Program to Decrease Rehospitalization
Jack, B. W., Chetty, V. K., Anthony, D., Greenwald, J. L., Sanchez, G. M., Johnson, A. E., Forsythe, S. R., O'Donnell, J. K., Paasche‐Orlow, M. K., Manasseh, C., et al. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-150-3-200902030-00007 · Cited by 1,613
Unintended Medication Discrepancies at the Time of Hospital Admission
Cornish, P. L., Knowles, S. R., Marchesano, R., Tam, V. C., Shadowitz, S., Juurlink, D. N., & Etchells, E. E. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.4.424 · Cited by 958
Role of Pharmacist Counseling in Preventing Adverse Drug Events After Hospitalization
Schnipper, J. L., Kirwin, J. L., Cotugno, M. C., Wahlstrom, S. A., Brown, B. A., Tarvin, E., Kachalia, A. B., Horng, M. S., Roy, C. L., McKean, S. C. W., et al. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.5.565 · Cited by 792
Posthospital Medication Discrepancies
Coleman, E. A., Smith, J. D., Raha, D., & Min, S. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.16.1842 · Cited by 696
Hospital-Based Medication Reconciliation Practices
Mueller, S. K., Sponsler, K. C., Kripalani, S. B., & Schnipper, J. L. (2012) · Archives of Internal Medicine · doi:10.1001/archinternmed.2012.2246 · Cited by 514
Medication Reconciliation During Transitions of Care as a Patient Safety Strategy
Kwan, J. L., Lo, L., Sampson, M., & Shojania, K. G. (2013) · Annals of Internal Medicine · doi:10.7326/0003-4819-158-5-201303051-00006 · Cited by 433
Classifying and Predicting Errors of Inpatient Medication Reconciliation
Pippins, J. R., Gandhi, T. K., Hamann, C., Ndumele, C. D., Labonville, S. A., Diedrichsen, E. K., Carty, M. G., Karson, A. S., Bhan, I., Coley, C. M., et al. (2008) · Journal of General Internal Medicine · doi:10.1007/s11606-008-0687-9 · Cited by 388
Kripalani, S. B., Roumie, C. L., Dalal, A. K., Cawthon, C., Businger, A., Eden, S. K., Shintani, A., Sponsler, K. C., Harris, L. J., Theobald, C., et al. (2012) · Annals of Internal Medicine · doi:10.7326/0003-4819-157-1-201207030-00003 · Cited by 315
Medication Reconciliation at Hospital Discharge: Evaluating Discrepancies
Wong, J. D., Bajcar, J., Wong, G. G., Alibhai, S. M. H., Huh, J., Cesta, A., Pond, G. R., & Fernandes, O. A. (2008) · Annals of Pharmacotherapy · doi:10.1345/aph.1l190 · Cited by 314
Standardization as a Mechanism to Improve Safety in Health Care
Rozich, J. D., Howard, R. J., Justeson, J. M., Macken, P. D., Lindsay, M. E., & Resar, R. K. (2004) · The Joint Commission Journal on Quality and Safety · doi:10.1016/s1549-3741(04)30001-8 · Cited by 294
Schnipper, J. L., Hamann, C., Ndumele, C. D., Liang, C. L., Carty, M. G., Karson, A. S., Bhan, I., Coley, C. M., Poon, E. G., Turchin, A., et al. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2009.51 · Cited by 239
Impact of a Pharmacist-Facilitated Hospital Discharge Program
Walker, P. C. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2009.398 · Cited by 228
A validated, reliable method of scoring the severity of medication errors
Dean, B. S., & Barber, N. (1999) · American Journal of Health-System Pharmacy · doi:10.1093/ajhp/56.1.57 · Cited by 184
Pharmacist Medication Assessments in a Surgical Preadmission Clinic
Kwan, Y. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.10.1034 · Cited by 173
Dedhia, P., Kravet, S. J., Bulger, J. B., Hinson, T., Sridharan, A., Kolodner, K., Wright, S. M., & Howell, E. E. (2009) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2009.02430.x · Cited by 172
Evaluation of the Contribution of Clinical Pharmacists: Inpatient Care and Cost Reduction
Hatoum, H. T., Hutchinson, R. A., Witte, K. W., & Newby, G. P. (1988) · Annals of Pharmacotherapy · doi:10.1177/106002808802200318 · Cited by 148
Bergkvist, A., Midlöv, P., Höglund, P., Larsson, L., Bondesson, Å., & Eriksson, T. (2009) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-009-0680-1 · Cited by 137
Nickerson, A., MacKinnon, N. J., Roberts, N., & Saulnier, L. (2005) · Healthcare Quarterly · doi:10.12927/hcq..17667 · Cited by 125
Eggink, R. N., Lenderink, A. W., Widdershoven, J. W. M. G., & van den Bemt, P. M. L. A. (2010) · Pharmacy World & Science · doi:10.1007/s11096-010-9433-6 · Cited by 116
The effect on medication errors of pharmacists charting medication in an emergency department
Vasileff, H. M., Whitten, L. E., Pink, J., Goldsworthy, S. J., & Angley, M. T. (2008) · Pharmacy World & Science · doi:10.1007/s11096-008-9271-y · Cited by 112
Evaluation of a hospital-based community liaison pharmacy service in Northern Ireland
Bolas, H., Brookes, K., Scott, M., & McElnay, J. C. (2004) · Pharmacy World & Science · doi:10.1023/b:phar.0000018601.11248.89 · Cited by 110
Johnston, R. M., Saulnier, L., & Gould, O. N. (2010) · The Canadian Journal of Hospital Pharmacy · doi:10.4212/cjhp.v63i5.947 · Cited by 104
Hawes, E. M., Maxwell, W. D., White, S., Mangun, J., & Lin, F.-C. (2013) · Journal of Primary Care & Community Health · doi:10.1177/2150131913502489 · Cited by 103
Impact of admission medication reconciliation performed by clinical pharmacists on medication safety
Leguelinel, G., Arnaud, F., Bouvet, S., Dubois, F., Castelli, C., Roux‐Marson, C., Ray, V., Sotto, A., & Kinowski, J. (2014) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2014.09.012 · Cited by 102
Medication Reconciliation Performed by Pharmacy Technicians at the Time of Preoperative Screening
van den Bemt, P. M. L. A., Broek, S. V. D., Nunen, A. K. V., Harbers, J. B. M., & Lenderink, A. W. (2009) · Annals of Pharmacotherapy · doi:10.1345/aph.1l579 · Cited by 95
van den Bemt, P. M. L. A., Loos, E. M. V. D. S.-D., van der Linden, C., Theeuwes, A. M. L. J., Pol, A. G., & The Dutch CBO WHO High 5s Study Group (2013) · Journal of the American Geriatrics Society · doi:10.1111/jgs.12380 · Cited by 89
Grimes, T., Duggan, C. A., Delaney, T. P., Graham, I. M., Conlon, K. C., Deasy, E., Jago‐Byrne, M., & Brien, P. O. (2010) · British Journal of Clinical Pharmacology · doi:10.1111/j.1365-2125.2010.03834.x · Cited by 88
Frydenberg, K., & Brekke, M. (2012) · Scandinavian Journal of Primary Health Care · doi:10.3109/02813432.2012.712021 · Cited by 77
Effect of clinical pharmacist intervention on medication discrepancies following hospital discharge
Farley, T. M., Shelsky, C., Powell, S., Farris, K. B., & Carter, B. L. (2014) · International Journal of Clinical Pharmacy · doi:10.1007/s11096-014-9917-x · Cited by 72
Pharmacist-led medication reconciliation to reduce discrepancies in transitions of care in Spain
Bandrés, M. Á. A., MENDOZA, M. A., Nicolás, F. G., Hernández, M. Á. C., & Iglesia, F. R. L. (2013) · International Journal of Clinical Pharmacy · doi:10.1007/s11096-013-9824-6 · Cited by 64
Beckett, R. D., Crank, C. W., & Wehmeyer, A. (2011) · Journal of Pharmacy Practice · doi:10.1177/0897190011422605 · Cited by 58
C., J. B., Martínez‐Martínez, F., & García‐Jiménez, E. (2013) · BMC Health Services Research · doi:10.1186/1472-6963-13-337 · Cited by 57
Collaborative pharmaceutical care in an Irish hospital: uncontrolled before-after study
Grimes, T., Deasy, E., Allen, A., O'Byrne, J., Delaney, T., Barragry, J., Breslin, N. P., Moloney, E. D., & Wall, C. A. M. (2014) · BMJ Quality & Safety · doi:10.1136/bmjqs-2013-002188 · Cited by 48
Assessing the quality of ward pharmacists' interventions
Eadon, H. (1992) · International Journal of Pharmacy Practice · doi:10.1111/j.2042-7174.1992.tb00556.x · Cited by 46
Medication reconciliation: passing phase or real need?
Durán-García, E., Fernandez-Llamazares, C. M., & Calleja‐Hernández, M. Á. (2012) · International Journal of Clinical Pharmacy · doi:10.1007/s11096-012-9707-2 · Cited by 36
Improving Medication Safety with Accurate Preadmission Medication Lists and Postdischarge Education
Gardella, J. E., Cardwell, T. B., & Nnadi, M. (2012) · The Joint Commission Journal on Quality and Patient Safety · doi:10.1016/s1553-7250(12)38060-4 · Cited by 34
Medication discrepancies at discharge from an internal medicine service
Herrero-Herrero, J. I., & García‐Aparicio, J. (2010) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2010.10.003 · Cited by 33
Utilizing community pharmacy dispensing records to disclose errors in hospital admission drug charts
Tompson, A., Peterson, G. M., Jackson, S., Hughes, J., & Raymond, K. (2012) · International Journal of Clinical Pharmacology and Therapeutics · doi:10.5414/cp201720 · Cited by 23
Cater, S. W., Luzum, M., Serra, A. E., Arasaratnam, M. H., Travers, D. A., Martin, I. B. K., Wei, T. L., & Brice, J. H. (2014) · Journal of Emergency Medicine · doi:10.1016/j.jemermed.2014.09.065 · Cited by 22
Kostas, T., Paquin, A. M., Zimmerman, K. M., Simone, M. J., Skarf, L. M., & Rudolph, J. L. (2013) · Aging Health · doi:10.2217/ahe.13.47 · Cited by 14
Flagged first, then by citations
Research works printed but not linked: 4
- Institute for Healthcare Improvement Medication reconciliation review http://www.ihi.org/resources/Pages/Tools/MedicationReconciliationReview.aspx
- National Institute for Health and Care Excellence, 2007, Technical Patient Safety Solutions for Medicines Reconciliation on Admission of Adults to Hospital
- Canadian Council on Health Services Accreditation, 2004, Patient Safety Goals and Required Organizational Practices
- Effective Practice and Organisation of Care (EPOC) [Data collection checklist and risk of bias]. EPOC Resources for review authors Oslo Norwegian Knowledge Centre for the Health Services 2014 http://epoc.cochrane.org/epoc-specific-resources-review-authors
Cited by
Sorted by citations
Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021.
Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., Machado, F. R., Mcintyre, L., Ostermann, M., Prescott, H. C., et al. (2021) · Critical Care Medicine · doi:10.1097/ccm.0000000000005337 · Cited by 2,935
Ravn-Nielsen, L. V., Duckert, M.-L., Lund, M. L., Henriksen, J. P., Nielsen, M. L., Eriksen, C. S., Buck, T. C., Pottegård, A., Hansen, M. R., & Hallas, J. (2018) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2017.8274 · Cited by 310
Impact of medication reconciliation for improving transitions of care
Redmond, P., Grimes, T., McDonnell, R., Boland, F., Hughes, C. M., & Fahey, T. P. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010791.pub2 · Cited by 201
Adverse drug reactions in primary care: a scoping review
Khalil, H., & Huang, C. (2020) · BMC Health Services Research · doi:10.1186/s12913-019-4651-7 · Cited by 150
Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021
Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., Machado, F. R., Mcintyre, L., Ostermann, M., Prescott, H. C., et al. (2021) · Intensive Care Medicine · doi:10.1007/s00134-021-06506-y · Cited by 5,082
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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
