Medication Discrepancies and Medication-Related Problems in Psychiatric Patients: A Medication Reconciliation Study

Background: Medication discrepancies (MDs) are common medication errors that can lead to adverse drug events (ADEs) and suboptimal treatment. Medication reconciliation (MR) programs are implemented in many countries, including Iran, to identify, resolve, and prevent MDs and other medication-related problems (MRPs). In the psychiatric setting, the importance of identifying and addressing MRPs is even greater due to the high prevalence of polypharmacy, limited patient cooperation, and other factors. This study aimed to investigate the prevalence of MDs and MRPs in psychiatric patients. Methods: This study included 302 psychiatric patients receiving at least two systemic medications daily. Their medications were reviewed at discharge using the Pharmaceutical Society of Australia (PSA) guidelines to identify MRPs. The collected data were analyzed statistically. Results: In this study, patients were taking a total of 1421 medications (4.71 medications per patient). A total of 493 MDs and 392 MRPs were identified. The most common MRPs were, in decreasing order, medication underuse or non-adherence by the patient (175 cases, 44.64% of all MRPs) and drug interactions (168 cases, 42.85%). The number of drug interactions significantly increased with the increasing number of underlying diseases and the number of medications used (P < 0.001 in both cases). A total of 594 interventions were made by the pharmacist, of which the most common were referrals to the physician for medication adjustments (193 cases, 32.27% of all interventions) and increasing the medication dose or prescribing a missed medication (172 cases, 28.95%). Conclusion: This study showed that the prevalence of MRPs in psychiatric settings is considerable and that implementing an MR program and pharmacist intervention in MRPs can significantly improve the quality of care.