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    Pharmacist-led interdisciplinary medication reconciliation using comprehensive medication review in gynaecological oncology patients: A prospective study

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    Author
    Son, H.
    Kim, J.
    Kim, C.
    Date
    2018
    Journal
    European Journal of Hospital Pharmacy
    Publisher
    BMJ Publishing Group
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://dx.doi.org/10.1136/ejhpharm-2016-000937
    Abstract
    Objectives: Medication reconciliation is a key part of transitional care. This study examined the implementation of a pharmacist-led medication reconciliation programme for short-term hospitalised patients and explored the barriers and benefits. Methods: A prospective study was conducted in patients admitted to a gynaecological oncology department. Medications were reconciled on admission using a 'comprehensive medication review (CMR)' strategy. Patients received a reminder text message and were asked to bring their medications a day before admission for scheduled chemotherapy. Upon admission, a pharmacist reviewed patients' admission prescriptions and home medications, including non-prescription medications, based on clinical status and laboratory test results. Drug-related problems and unused or expired medications were assessed. Satisfaction with the CMR service and reasons for non-compliance were surveyed by an individual interview. The cost of the unused or expired medications was calculated based on the average drug acquisition cost. Results: Sixty-four interventions in 95 patients were performed during the study - namely, correction of treatment duration (34 cases, 53.1%), recommendation of medications for untreated indications (18 cases, 28.1%), correct drug selection (5 cases, 7.8%), discontinuation of duplicate medications (4 cases, 6.3%), correction of dose, provision of alternatives for drug-drug interactions, unintended omissions (1 case each, 1.6%). The difference in the cost of unused or expired drugs before and after programme implementation was about US$1700. Conclusions: Pharmacist-led medication reconciliation targeting short-term hospitalised patients improved drug use, prevented medication waste and reduced healthcare costs. Copyright 2018 Published by the BMJ Publishing Group Limited.
    Keyword
    comprehensive medication review
    gynecologic oncology
    hospitalized patients
    medication reconciliation
    pharmacists
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85049258873&doi=10.1136%2fejhpharm-2016-000937&partnerID=40&md5=a07208299b4b79a48f663a74910d0e2e; http://hdl.handle.net/10713/9189
    ae974a485f413a2113503eed53cd6c53
    10.1136/ejhpharm-2016-000937
    Scopus Count
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    UMB Open Access Articles 2018

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