A new study suggests that acknowledging healthcare practitioners’ varying perspectives on the purpose of medication reconciliation and their roles in the process might increase implementation in healthcare settings such as hospitals and nursing homes.
Amy Vogelsmeier, assistant professor in the MU Sinclair School of Nursing, and researchers from the Salt Lake City Veteran’s Affairs Medical Center and the University of Utah found that healthcare professionals often viewed medication reconciliation as a “checklist” task rather than a higher-level thinking process that involves considering patients’ entire therapeutic plans.
“Medication reconciliation is more than just matching medication lists when patients transition among hospitals, personal residences, nursing homes and other healthcare settings,” Vogelsmeier said. “It’s an opportunity to ask whether medications are still appropriate and consistent with the patients’ therapeutic goals and then to make adjustments to their medication regimens if needed. The constant surveillance of medications is critical because adverse drug events happen when people are taking medications they no longer need or aren’t taking medications they need.”
Vogelsmeier analyzed data gathered by colleagues in Utah from focus groups with physicians, nurses and pharmacists at three U.S. Department of Veteran’s Affairs Health Administration hospitals. Professionals in the three disciplines perceived their roles in medication reconciliation differently. In reality, joint and overlapping responsibilities require that the healthcare practitioners collaborate to ensure patient safety, Vogelsmeier said.
Vogelsmeier says maintaining accurate and reliable medication lists is difficult, and current computerized systems found in many hospitals, nursing homes and physician clinics do not support the maintenance of accurate medication profiles. She suggests that computerized information systems be designed to integrate input from each health practitioner role into the medication reconciliation process so that practitioners can provide up-to-date information to ensure accuracy of records. Other issues that emerged in the focus groups included non-adherence to medication regimens and low health literacy.
The study, “Medication reconciliation: A qualitative analysis of clinicians’ perceptions,” is published in the journal Research in Social and Administrative Pharmacy.