When patients check into the hospital, they usually provide a medical history, including the medications they are taking at the time of admission. Patients cannot always provide a complete and accurate list of medications for various reasons. This and other factors may result in unintentional discrepancies between the medications a patient was taking prior to hospital admission, the medications they receive during their hospital stay, and the medications they are prescribed upon their discharge. Some of these discrepancies may be harmful, resulting in “adverse drug effects” (ADEs). A study by researchers at Johns Hopkins examined whether specially-trained teams of nurses and pharmacists could review patients’ medication histories to identify discrepancies and prevent ADEs. It concluded that such teams could not only prevent many ADEs, but could do so at a potential cost saving to hospitals and patients.
The study, titled “Nurse-pharmacist collaboration on medication reconciliation prevents potential harm” and published in the May/June issue of the Journal of Hospital Medicine, involved 563 patients who stayed at an urban hospital at various times between January 2008 and March 2009. Doctors conducted interviews with patients to obtain a home medication list (HML), which they used to determine what medications to administer during their hospital stay. Nurses would interview the patients a second time, creating another medication list. The nurses would review electronic records from prior hospital discharges, and sometimes they would contact a patient’s pharmacist, primary care physicians, and family members to obtain additional information on their medications. The lead researcher described this process as “detective work.” The patients could review these second HML’s for accuracy.