Albany Medical Center, Albany, NY 12208, USA.
Am J Emerg Med. 2012 Sep;30(7):1048-54. doi: 10.1016/j.ajem.2011.06.038. Epub 2011 Aug 19.
Medication reconciliation is a Joint Commission for the Accreditation of Healthcare Organizations requirement to reduce medication errors. This study evaluated the reliability of patient-completed medication reconciliation forms (MRs) compared with pharmacy-generated lists and determined if there was a difference in concordance when patients completed the forms from memory compared with when they brought a separate list or pill bottles.
We prospectively enrolled patients with completed MRs. Research assistants contacted the patient's pharmacy to determine medications filled in the prior 3 months, which was compared with the MR. Discrepancies and the method by which the patient completed the MR (memory, list, or pill bottles) were recorded.
Three hundred fifteen patients were enrolled. Thirty-three percent made errors of omission (reported by pharmacy, but not on MR), 12.7% made errors of addition (reported on MR, but not by pharmacy), 18.1% made both types of errors, and 36.3% made no errors. Patients with errors were on 5.6 medications compared with 3.6 medications for those without errors (P < .0001). Those completing the MR from a list made 2.3 errors compared with 1.2 for those completing from memory and 1.8 for those completing from their pill bottles (P < .001). Of 390 medications omitted from patient lists, 16% were cardiac medications, 13% were neuropsychiatric agents, and 9.5% were narcotics.
Thirty-six percent of patients were able to provide a medication list that matched their pharmacy-prescribed drugs. More errors were noted from patients taking more medications and from those completing their MR from a separate list.
药物重整是联合委员会认证医疗机构组织的要求，旨在减少药物错误。本研究评估了患者填写的药物重整表（MR）与药房生成的清单的可靠性，并确定当患者凭记忆填写表格与凭单独清单或药瓶填写时，在一致性方面是否存在差异。
我们前瞻性地招募了已完成 MR 的患者。研究助理联系患者的药房以确定在过去 3 个月内配药情况，然后将其与 MR 进行比较。记录差异以及患者填写 MR 的方法（记忆、清单或药瓶）。
共纳入 315 名患者。33%的患者出现遗漏错误（药房报告，但 MR 上未报告），12.7%的患者出现添加错误（MR 上报告，但药房未报告），18.1%的患者出现这两种类型的错误，36.3%的患者没有错误。有错误的患者服用 5.6 种药物，而无错误的患者服用 3.6 种药物（P <.0001）。从清单中填写 MR 的患者有 2.3 个错误，而凭记忆填写的患者有 1.2 个错误，凭药瓶填写的患者有 1.8 个错误（P <.001）。在患者的清单中遗漏的 390 种药物中，有 16%是心脏药物，13%是神经精神药物，9.5%是麻醉剂。
36%的患者能够提供与他们药房开具的药物相匹配的药物清单。服用更多药物的患者和从单独清单填写 MR 的患者更容易出现错误。
