New research published in Diabetes Care highlights the importance of conducting medication reconciliation, especially in patients diagnosed with diabetes. The researchers emphasized the importance of reconciling all medications; however, they found improvements even when just some of the medications were reconciled.
Lead author Alexander Turchin, MD, MS, associate professor, Harvard Medical School, Boston, Massachusetts, and his team affiliated with Brigham and Women’s Hospital, Boston; Baim Institute for Clinical Research, Boston; and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, explored the association of the completion of medication-reconciliation assessments and less frequent emergency department (ED) admissions and decreased hospitalizations. Researchers examined 31,689 adults who were treated in primary-care facilities and were taking at least one medication for diabetes. They evaluated the portion of diabetes medications reconciled over 6 months and the potential relationship to the primary outcome of combined frequency of hospitalizations and visits to the ED.
Among 261,765 reconciliation-assessment periods contributed by the 31,689 patients, 176,274 (67.3%) had all diabetes medications reconciled, 27,775 (10.6%) had some degree or partial reconciliation, and 57,716 (22.1%) had none of the diabetes medications reconciled. Individuals who received complete, partial, or no diabetes medication reconciliation had 0.354, 0.377, and 0.384 primary outcome events per 6 months, respectively (P <.0001). Medications were considered to be reconciled if any of the following actions were performed in the electronic medical record (EMR): medication record was edited, prescription was generated, or medication was confirmed on a special EMR reconciliation screen.
Researchers determined that having some or all of the diabetes medications reconciled was associated with a lower risk of the primary outcome than having no medication reconciled. And they found that feedback provided directly to providers on performance was associated with a significant increase in the odds for patients to receive complete (all diabetes medications) medication reconciliation.
Because little is known about factors that influence medication reconciliation, the authors suggest this study demonstrates that a quality-improvement program that provides performance feedback can improve reconciliation efforts. Conversely, the researchers determined that several demographic characteristics—such as white race and English as the primary language—were associated with lower medication reconciliation rates, noting, “The reasons for this finding are uncertain and deserve additional investigation.”
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