A Comparison of Two Methods of Medication Reconciliation

Abstract

Objectives: To compare the completeness of patient medication history collected upon admission at the University Medical Center (UMC) in Tucson, Arizona with that collected by RxAccordTM insurance claims database. Methods: An inferential retrospective chart review. A random list of 300 patients admitted to UMC from January 1, 2007 to June 30, 2007 who utilized specific insurance companies was obtained. Of those 300 patients, the first 100 patients found in the RxAccordTM database were included in this study. UMC recorded admission medication history was noted for each patient and compared against the RxAccordTM retail pharmacy adjudicated medication database. The main outcome measured was the number of medication discrepancies. The independent variable was the type of medication reconciliation conducted (RxAccordTM ) vs. physician compiled upon admission to UMC. Results: A total of ninety-five charts were used in this study. UMC admission medication reconciliation records had an average of 2.21 missing medications per patient whereas RxAccordTM had an average of 1.01 missing medications per patient. Of the medications missing on the RxAccordTM database, almost 50% (46/96) were OTC medications. On average, UMC had fifty-one medications that had discrepancies (i.e. route, strength or directions). On the other hand, RxAccordTM contained no discrepancies. A total of 17 out 95 records (18%) were missing medication reconciliation forms in their medical record. Conclusions: Information collected by RxAccordTM produced a more complete patient medication reconciliation history than that compiled upon admission at UMC. An insurance claims database may provide, a significantly more accurate method of medication reconciliation.