Effectiveness of Pre-Consultation Medication Reconciliation Service in Reducing Unintentional Medication Discrepancies During Transition of Care From Hospital Discharge to Primary Care Setting

National Healthcare Group, Singapore

Status: Completed

Conditions: Medication Adherence; Medication Administered in Error

Treatments: Other: Pre-Consultation Medication Reconciliation

Study type: Interventional

Funder types: Other

Identifiers

NCT03181906

DSRB2015/01219

Details and patient eligibility

About

This study evaluates the the effectiveness of pre-consultation Medication Reconciliation Service in reducing unintentional medication discrepancies among patients who discharged from hospital to primary care.

Full description

Medication discrepancies during care transition were common. Many factors contribute to the risk of medication discrepancies. Despite medication reconciliation service being practiced in the hospital setting, there was limited knowledge on its effectiveness in the primary care setting. This study aims to evaluate the effectiveness of a pre-consultation medication reconciliation service in reducing medication discrepancies in patients who transit from hospital to primary care. Adult patients who made their first visit to the polyclinics following a recent hospital discharge and were prescribed with 5 or more chronic medications were randomised to 2 groups. Pre-consultation medication reconciliation by a pharmacist was carried out for the intervention group. Outcome was assessed by a different pharmacist who was blinded to the randomised allocation. The control group underwent usual care without a pre-consultation medication reconciliation.

Enrollment: 200 patients

Sex: All

Ages: 21+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

1. Age 21 years and older
2. Patient or primary caregiver was able to provide informed consent
3. Patient or primary caregiver was English, Mandarin or Malay speaking
4. Patient was able to self-administer medications, or accompanied by a caregiver who assisted in administering medications
5. Patient was prescribed 5 or more chronic medications
6. The day of the study visit was the first follow-up visit in National Healthcare Group Polyclinics for chronic disease management after recent discharge from a local public hospital

Exclusion criteria

1. Residents of nursing home
2. The day of the study visit was for acute illness consult
3. Unwilling to consent to a 30-day follow-up phone call.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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200 participants in 2 patient groups

Pre-Consultation Medication Reconciliation

Experimental group

Description:

Participants underwent medication reconciliation service before their consultation with the attending doctor. A best possible medication history (BPMH) was created and saved as an electronic draft in the electronic medical record system.

Treatment:

Other: Pre-Consultation Medication Reconciliation

Control

No Intervention group

Description:

Participants in the control group proceeded with usual care, where the doctor reviewed the patient's condition and ordered an electronic prescription