Medication reconciliation is a major focus of quality measurement activities, and according to The Joint Commission, primary care clinicians are expected to reconcile a patient’s medications at every visit. Medication reconciliation is sometimes defined as the comparison of medication lists at admission or discharge and is sometimes defined more broadly to include information from the patient. However, these concepts set the bar too low. What is needed is not merely a reconciled list, but the correct medication list. Achieving this list would involve multiple levels of reconciliation.
Levels of Medication Reconciliation
- Clinician agreement – All of the clinicians who provide care for the patient need to agree which medications should be on the list.
- Patient agreement – Incorporating the patient’s perspective is fundamental. Identifying medications that the patient cannot obtain or choose not to take.
- Deprescribe – Inappropriate and unnecessary medications should be removed from the list.
- Decrease patient burden – Minimized by choosing medications given fewer times per day and aligning dosing intervals to reduce the frequency that medications should be taken.
- Minimize out-of-pocket expenses – Unnecessarily expensive medications do not belong on the list; a medication the patient cannot afford will not help.
- Inform outside entities – The correct medication list will not be effective unless all entities interacting with the patient also have the list.
It will likely be time-consuming to develop and maintain the correct medication list. However, there are many reasons why a correct medication list is beneficial for prescribers, but most importantly, for patients. Check out the full article, recently published by JAMA, which outlines specific steps necessary to move beyond medication reconciliation and to achieve the correct medication list.
The Great Plains QIN is partnering with providers, pharmacists, communities and stakeholders across our region to advance patient safety by improving medication reconciliation and thereby reducing ADEs. We have gathered tools and resources to help your organization or community implement processes to facilitate better medication reconciliation. Click here to learn more.