Medication Interaction and Physicians' Compliance Assessment through Medication Reconciliation Forms in a University Affiliated Hospital

Document Type: Research article

Authors

1 Department of Clinical Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Woodbridge High School, Irvine, CA, USA

3 Chronic Respiratory Disease Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Disease (NRITLD), MasihDaneshvari Hospital, Tehran, Iran

Abstract

Background: Medication interactions are associated with various unwanted adverse drug reactions. Medication Reconciliation involves a process in which a complete list of patient's previously prescribed medications are recorded and subsequently evaluated within the context of concomitantly prescribed medications and present medical condition during the hospitalization.

Method: Medical records of randomly selected 270 patients hospitalized in internal medicine, cardiovascular and infectious diseases wards were evaluated. Drug interactions were checked by LexiComp® database. Each interaction was assigned a risk rating of A, B, C, D, or X. The progression from A to X was based on increased urgency for responding to the data. Completed reconciliation forms were attached to patient charts for evaluation of physicians' compliance.

Results: Drug interactions were observed in 65.2% (176/270) of cases. The risk rating of interactions was categorized as C, D and X in 54.2%, 32.4% and 13.4% of cases, respectively. There was a positive correlation between the number of prescribed medications and the rate of interactions (p-value<0.001, Kendall's correlation coefficient= 0.487). Moreover, the length of hospitalization and the rate of drug interactions were significantly correlated (p-value<0.001, Kendall's correlation coefficient= 0.350). Cardiovascular agents constituted the largest proportion of interactions (25%) followed by antibiotics (18%) and immunosuppressive agents (6%). In 59.6% of cases, no corrective action was taken by the physicians.

Conclusion: Medication discrepancies occur commonly in hospital settings. Structured medication reconciliation may have a positive impact on prevention of medication errors.

Keywords

Main Subjects