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- Title
Characterization of Admission Medication Reconciliations Performed by Pharmacists in a Pediatric Institution: Resource Allocation.
- Authors
Nolt, Valerie D.; Patel, Tulsi M.; Forbes-Osborne, Marie A.; Osborne, Samuel B.; Gardner, Brian M.; Kuhn, Robert J.
- Abstract
BACKGROUND Compared with adults, children may be at greater risk of medication errors and potential adverse effects. The American Academy of Pediatrics recommends developing mechanisms for proactively identifying patients at risk for medication-related adverse events and failed reconciliation. This study's primary purpose was to evaluate pediatric patients admitted to identify risk factors requiring pharmacist intervention during medication reconciliation (MedRec). METHODS This prospective study included pediatric patients admitted during the study time frame until the target population of 500 patient encounters was achieved. During each admission, pharmacy staff completed a medication history, after which a pediatric pharmacist completed a MedRec, as is standard hospital practice. The primary outcome was identification of factors for high-risk transitions of care during pediatric admissions based on the need for pharmacist interventions during the MedRec process. RESULTS In total, 331 interventions were made for 127 patients (median 2; range, 1-12). Of the 331 interventions, 196 (59.2%) were classified as being of moderate or significant severity. Although patients with at least 2 home medications were significantly more likely to require any intervention (p < 0.0001), patients with 5 or more home medications were more likely to have a significant intervention. CONCLUSION Identifying patients with home medications could allow for focused efforts to intervene. Also, patients admitted to the PICU or those with cardiology- or endocrinology-related diagnoses should be prioritized for MedRec process, because of the likelihood of requiring multiple home medications. This strategy should be tailored to individual pediatric institutions based on internal quality control assessments and available resources. ABBREVIATIONS GenPeds, general pediatrics; KCH, Kentucky Children's Hospital; MedHx, medication history; MedRec, medication reconciliation; Medical SubSpec, medical subspecialty; Min-I, minor intervention; Mod-I, moderate intervention; PICU, pediatric intensive care unit; Sig-I, significant intervention
- Subjects
MEDICATION errors; DRUG side effects; DRUGS; MEDICATION reconciliation; ASSESSMENT &; Accountability in Language Education Programs (Book); EVALUATION
- Publication
Journal of Pediatric Pharmacology & Therapeutics, 2020, Vol 25, Issue 2, p139
- ISSN
1551-6776
- Publication type
Article
- DOI
10.5863/1551-6776-25.2.139