Electronic Medication Reconciliation in Hospitals: a Systematic Review and Meta-analysis

Overview

Journal Eur J Hosp Pharm

Publisher BMJ Publishing Group

Specialty Pharmacy

Date 2019 Jun 4

PMID 31157034

Citations 10

Authors

Hongmei Wang

Long Meng

Jie Song

Jiadan Yang

Juan Li

Feng Qiu

Affiliations

Soon will be listed here.

Abstract

Objective: Medication reconciliation (MedRec) is recognised as a multiprofessional process for the prevention of medication discrepancies. The goal of this study is to evaluate the available electronic medication reconciliation (eMedRec) tools and their effect on unintended discrepancies that occur in hospital institutions.

Method: PubMed, EMBASE, the Cochrane Library, Web of Science, the ClinicalTrials.gov website and four other Chinese databases were searched for relevant studies starting from their inception through October 2017. Methodological quality was assessed using the nine standard criteria of Cochrane Effective Practice and Organisation of Care Review Group (EPOC) and meta-analysis was performed using RevMan5.3 software.

Results: A total of 13 studies (three randomised controlled trials and 10 non-randomised controlled trials) were identified. Meta-analysis results demonstrated a reduced number of medications with unintended discrepancies (relative risk (RR)=1.85, 95% confidence interval (CI) 1.55 to 2.21), while no statistically significant differences were observed in the number of patients with unintended medication discrepancies (RR=2.74, 95% CI 0.59 to 12.73). Common discrepancies included medication omission, dose discrepancy, and frequency discrepancy. We found that the clinical impact of medication discrepancy was mild. A total of 12 electronic tools were reported and were mostly integrated into the hospital's information system. However, the usability, user adherence, and user satisfaction were found to lack sufficient evidence.

Conclusion: eMedRec was shown to reduce the incidence of medication with unintended discrepancies and improve medication safety. However, the electronic tools are diversified and the effects on other outcomes still require a comprehensive evaluation.

Systematic Review Registration: PROSPERO CRD42017067528.

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