Impact of a Medication Reconciliation Improvement Package on Adherence to Medication Reconciliation Among Internal Medicine Physicians: A Quality Improvement Project in a Lower-Middle Income Country.

IF 0.8 Q4 PHARMACOLOGY & PHARMACY Hospital Pharmacy Pub Date : 2024-12-01 Epub Date: 2024-05-28 DOI:10.1177/00185787241253442
Saad Bin Zafar Mahmood, Fazal Rehman, Aisha Jamal, Naureen Ali Meghani, Madiha Iqbal, Ambreen Amirali, Aysha Almas
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Abstract

Background: Medication reconciliation is one of the best measures to prevent medication-related errors at the time of admission and discharge of patients. We conducted a quasi-experimental study to evaluate the impact of a Medication reconciliation improvement package (intervention) on adherence to medication reconciliation at the time of admission in Department of Internal Medicine. The study included all adult patients admitted to internal medicine from August 2019 to December 2020. Pre-intervention data on adherence to medication reconciliation was less than 50%. The study involved creation of a quality improvement team to conduct a root-cause analysis which identified the need to target physician related issues and hence drafted a medication reconciliation improvement package which included meetings with physicians on the internal medicine floor, dedicated WhatsApp groups for repeated reminders, and appreciation messages for timely adherence. We used the Chi Square test to check the association between adherence to medication reconciliation and physicians and acuity level. Findings: We included 7914 records of patients, in which 4471 participants (56.4%) were from pre-intervention phase and 3443 (43.5%) were from intervention groups. The overall adherence to medication reconciliation was 54.3% (4297/7914). Adherence of medication reconciliation increased from 44.4% (1983/4471) in the pre-intervention phase to 67.2% (2314/3443) in the intervention phase (P < .001). Improvement was observed in adherence of medication reconciliation done by residents and in low acuity areas (P < .005). Conclusion: The Medical reconciliation improvement package is a simple low-cost intervention that resulted in improvement in adherence to medication reconciliation but needs further studies to assess its sustainability. However, it awaits to be seen if the same improvement can also be replicated to qualitative medication errors and clinical outcomes respectively.

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用药调和改进包对内科医生坚持用药调和的影响:一个中低收入国家的质量改进项目》。
背景:在患者入院和出院时,药物协调是预防用药相关错误的最佳措施之一。我们开展了一项准实验研究,以评估 "用药协调改进包"(干预措施)对内科入院时坚持用药协调的影响。研究对象包括 2019 年 8 月至 2020 年 12 月期间内科收治的所有成人患者。干预前的药物调节依从性数据低于 50%。该研究涉及成立一个质量改进小组,以进行根本原因分析,从而确定有必要针对与医生相关的问题进行改进,并因此起草了一套药物协调改进方案,其中包括与内科楼层的医生举行会议、在专门的 WhatsApp 群组中反复提醒,以及为及时坚持用药而发送感谢信息。我们使用卡方检验法检验了遵守药物协调与医生和急性病水平之间的关联。研究结果我们纳入了 7914 份患者记录,其中 4471 人(56.4%)来自干预前阶段,3443 人(43.5%)来自干预组。药物调节的总体依从性为 54.3%(4297/7914)。坚持药物协调的比例从干预前阶段的 44.4%(1983/4471)上升到干预阶段的 67.2%(2314/3443)(P P 结论:医疗协调改进方案是一项简单、低成本的干预措施,可改善对药物协调的依从性,但需要进一步研究以评估其可持续性。不过,同样的改进是否也能分别用于定性用药错误和临床结果,还有待观察。
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来源期刊
Hospital Pharmacy
Hospital Pharmacy PHARMACOLOGY & PHARMACY-
CiteScore
1.70
自引率
0.00%
发文量
63
期刊介绍: Hospital Pharmacy is a monthly peer-reviewed journal that is read by pharmacists and other providers practicing in the inpatient and outpatient setting within hospitals, long-term care facilities, home care, and other health-system settings The Hospital Pharmacy Assistant Editor, Michael R. Cohen, RPh, MS, DSc, FASHP, is author of a Medication Error Report Analysis and founder of The Institute for Safe Medication Practices (ISMP), a nonprofit organization that provides education about adverse drug events and their prevention.
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