Medication review software to improve the accuracy of outpatient medication histories: protocol for a randomized controlled trial

Abstract

Medication-prescribing errors generated at interfaces-in-care are the most common cause of preventable health care errors and contribute substantially to adverse patient outcomes. For this reason, standardized medication reconciliation (MR) processes need to be inserted at these interfaces. However, MR is an inherently complex task, and little data exist to inform system-based operationalization. The Portland Informatics Center addressed this challenge by creating an electronic patient-directed multimedia survey to automate the medication history collection. This article describes a research protocol designed to compare the software's medication discrepancy detection rate with traditional history collection strategies. For this randomized, controlled, single-blind trial, participants are randomly allocated into one of two groups: the control group reviews a paper list printed from the electronic record, whereas the intervention group uses a computer-assisted reconciliation survey that includes display of visual data (i.e., medication pictures). C 2011 Wiley Periodicals, Inc.

Evaluation of Multimedia Medication Reconciliation Software: A Randomized Controlled, Single-Blind Trial to Measure Diagnostic Accuracy for Discrepancy Detection

“…52 In our adaptation of the framework, MR is a cyclical macroprocess composed of linked subprocesses (e.g., history collection, data adjudication, discrepancy resolution). 53 The quality of MR can only be as effective as the initial history. 35,53 We therefore designed our intervention to address system constructs supporting history collection.…”

“…53 The quality of MR can only be as effective as the initial history. 35,53 We therefore designed our intervention to address system constructs supporting history collection. 23,[52][53][54] The PSE contends that humans encode, store, and retrieve images from memory more easily than text or auditory information.…”

“…35,53 We therefore designed our intervention to address system constructs supporting history collection. 23,[52][53][54] The PSE contends that humans encode, store, and retrieve images from memory more easily than text or auditory information. [55][56][57] Studies indicate patient education materials using pictures and pictograms can influence health literacy and improve comprehension.…”

Clinical Pharmacist and Physician Team Collaboration to Improve Medication Safety and Cost Savings in an Inpatient Medicine Unit: A Prospective Cohort Study

“…Potential ADEs are medication errors that have the potential to cause harm, but were intercepted by pharmacist's intervention or before reaching the patient [16,17]. Our events were assigned probability of harm scores which were adapted from other studies [3,7,[18][19][20] with few modifications and ranged from 0.1 to 1. A probability of harm score of 1 was given to an actual ADE identified and intercepted by the clinical pharmacist [3,7].…”

A web application to involve patients in the medication reconciliation process: a user-centered usability and usefulness study (Preprint)

“…A randomized controlled trial is ongoing to assess the accuracy of this software in comparison to a gold standard [70]. Schnipper et al [22,23,71] reported that patients using a medication module embedded in the Patient Gateway, an online patient health record, had fewer potentially harmful discrepancies.…”