The impact of medication reconciliation on discrepancies and all-cause readmission among hospitalized patients with chronic kidney disease: A quasi-experimental study
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Introduction
Chronic kidney disease (CKD) with its associated comorbidities and pill burden can expose patients to a heightened risk of drug-related problems, including medication discrepancies.
This study aimed to evaluate the impact of medication reconciliation supplemented with medication review on the number of medication discrepancies at discharge and all-cause readmission among CKD patients.
Methods
This was a quasi-experimental trial among adult CKD patients admitted into two major referral hospitals in northern Jordan. Patients in the intervention group received medication reconciliation supplemented with medication review by a clinical pharmacist, while those in the control group received the usual care. The recognized discrepancies were evaluated at admission and at discharge in both groups. Participants were followed for 90-day readmission.
Results
Among patients in the intervention group, the average number of discrepancies was 2.5±2.2 per CKD patient. Compared to the control group, the reduction in discrepancy numbers between admission and discharge was higher in the intervention group by 1.66 discrepancies. The likelihood of 90-day readmission was significantly lower in the intervention group (OR=0.41; P=0.002).
Conclusion
Supplemented medication reconciliation among CKD patients reveals a favorable impact on medication discrepancies and readmission rates. Optimizing medication management during transitions of care can improve overall health outcomes.
Impact of findings on practice statements
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Activating the role of clinical pharmacists in providing medication reconciliation can decrease medication discrepancies and enhance clinical outcomes particularly in hospitalized CKD patients.
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Designing and implementing an effective interprofessional collaborative approach in the hospital settings might boost the benefits achieved from transition-of-care services.
