Should nurses or clinical pharmacists perform medication reconciliation? A randomized controlled trial

Aag, Trine Iversen; García, Beate Hennie; Viktil, Kirsten K.

doi:10.1007/s00228-014-1741-7

Cited by 26 publications

(25 citation statements)

References 13 publications

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“…Nonetheless, they were found to spend less time in providing reconciliation services compared with physicians and nurses [15]. There is currently a great misconception among all healthcare providers regarding the role of pharmacists in providing the reconciliation service [10,15]. Some nurses and physicians believe that a better quality service would be achieved when pharmacists take a more active role in the reconciliation process while others believe that pharmacists are incapable of providing such services [10,15].…”

Section: Introductionmentioning

confidence: 99%

Hospital pharmacy medication reconciliation practice in Jordan: perceptions and barriers

Hammour

Farha

Basheti

2016

Evaluation Clinical Practice

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Section: Introductionmentioning

confidence: 99%

Hospital pharmacy medication reconciliation practice in Jordan: perceptions and barriers

Hammour

Farha

Basheti

2016

Evaluation Clinical Practice

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“…Pharmacy technicians and other support personnel can help obtain and organize relevant patient data for assessment by the clinical pharmacist in both direct patient care and population health initiatives. Many examples involving pharmacy technicians in the medication reconciliation process exist, 34,35,58,59,[63][64][65][66][67][68][69][70][71] and successful examples are available in a wide range of practices and settings, including emergency departments, 59,[63][64][65][66]72 pediatrics, 67 geriatrics, 68 hemodialysis units, 69 mental health, 70 and academic medical centers 58 and in preoperative screenings. 71 Medication histories from certified technicians are at least as accurate as medication histories from other members of the health care team.…”

Section: Assessment Of the Patientmentioning

confidence: 99%

“…71 Medication histories from certified technicians are at least as accurate as medication histories from other members of the health care team. 34,35,59,67 Beyond the reconciled medication list, trained technicians can use standardized communication (eg, "cue cards" with questions) to collect additional information on other aspects of patient care (eg, adherence, immunization status), which the clinical pharmacist can then review and assess in the ambulatory care or community setting. 42 Certified medical assistants, certified nursing assistants, and licensed practical nurses routinely initiate a patient's visit for other health care practitioners by placing the patient in an examination room, taking vital signs, and verifying medication.…”

Section: Assessment Of the Patientmentioning

confidence: 99%

“…• Use of pharmacy staff was recommended to achieve best patient outcomes [33][34][35][36][37][38] • Histories obtained by pharmacy technicians were more accurate than those obtained by nurses 35,36 • Pharmacy technician-led discharge medication reconciliation improved transitions of care and identified drug therapy problems 33 • No difference in discrepancies between pharmacist and pharmacy technician 37 • Discrepancies with higher clinical impact were more likely to be identified by pharmacy personnel than by usual care 37 • Pharmacists spent less time than nurses in medication reconciliation; physicians more often agreed with recommendations from pharmacists than from nurses 34 Preventive health Medical assistants, licensed practical nurses, pharmacy technicians…”

Section: Pharmacy Techniciansmentioning

confidence: 99%

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Best practices: Incorporating pharmacy technicians and other support personnel into the clinical pharmacist's process of care

Borchert

Phillips

Bastin

et al. 2018

J Am Coll Clin Pharm

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Changes to the U.S. health care landscape have increased the focus on the quality and use of alternative payment models, with a growing focus on value. As health care costs continue to rise, clinical pharmacists will increasingly engage in roles to expand the breadth and depth of clinical services in providing comprehensive medication management (CMM) to improve patient outcomes. The roles of pharmacy technicians and other support personnel must evolve to meet the needs created by this practice change and allow pharmacists to focus their services on activities that use their expertise to improve medication outcomes. Support personnel, including pharmacy technicians, should be identified to assist with clinical pharmacy tasks on the basis of their skills. To ensure competence, support personnel should be adequately trained and (if applicable) certified. Moreover, support personnel should be optimally incorporated into appropriate components of the clinical pharmacist's process of care to expand the reach and depth of clinical pharmacy services. When supervised by the pharmacist or others as defined in state practice acts, support personnel may be able to assist in the clinical pharmacist's provision of CMM. Finally, research should be conducted and disseminated on the utility and outcomes achieved using support personnel in the clinical pharmacist's process of care.

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“… 19 , 20 Pharmacists often find themselves in conflict with other health care providers (eg, nurses and physicians), regarding whether their medication-related services are superior in clinical impact while remaining cost-effective. 21 , 22 There is some evidence that pharmacists are the best suited health care professionals at providing the following medication-related services: 1) determining the most effective and parsimonious list of medications clinically appropriate to a patient; 21 , 23 2) working with patients to increase their health literacy regarding their medications; 24 and 3) facilitating patient motivation to take their medications as directed. 10 , 25 Successful community pharmacist-led interventions that are targeting medication adherence improvement should involve pharmacy services that encompass these three elements.…”

Section: Proposed Frameworkmentioning

confidence: 99%

Improving medication adherence: a framework for community pharmacy-based interventions

Pringle

Coley

2015

IPRP

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Evidence supports that patient medication adherence is suboptimal with patients typically taking less than half of their prescribed doses. Medication nonadherence is associated with poor health outcomes and higher downstream health care costs. Results of studies evaluating pharmacist-led models in a community pharmacy setting and their impact on medication adherence have been mixed. Community pharmacists are ideally situated to provide medication adherence interventions, and effective strategies for how they can consistently improve patient medication adherence are necessary. This article suggests a framework to use in the community pharmacy setting that will significantly improve patient adherence and provides a strategy for how to apply this framework to develop and test new medication adherence innovations. The proposed framework is composed of the following elements: 1) defining the program’s pharmacy service vision, 2) using evidence-based, patient-centered communication and intervention strategies, 3) using specific implementation approaches that ensure fidelity, and 4) applying continuous evaluation strategies. Within this framework, pharmacist interventions should include those services that capitalize on their specific skill sets. It is also essential that the organization’s leadership effectively communicates the pharmacy service vision. Medication adherence strategies that are evidence-based and individualized to each patient’s adherence problems are most desirable. Ideally, interventions would be delivered repeatedly over time and adjusted when patient’s adherence circumstances change. Motivational interviewing principles are particularly well suited for this. Providing effective training and ensuring that the intervention can be delivered with fidelity within a specified workflow process are also essential for success. Utilizing this proposed framework will lead to greater and consistent success when implementing pharmacist-led medication adherence interventions in the community pharmacy setting.

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Should nurses or clinical pharmacists perform medication reconciliation? A randomized controlled trial

Cited by 26 publications

References 13 publications

Hospital pharmacy medication reconciliation practice in Jordan: perceptions and barriers

Hospital pharmacy medication reconciliation practice in Jordan: perceptions and barriers

Best practices: Incorporating pharmacy technicians and other support personnel into the clinical pharmacist's process of care

Improving medication adherence: a framework for community pharmacy-based interventions

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