Understanding Medication Reconciliation Needs at a Family Medicine Residency Principal Investigator: Dr. Morgan Sayler Herring, PharmD, BCPS Co-Investigators: Olivia Altemeier, Jordyn Anderson, Kelly Tocki, Louis Swaka

MEDICATION RECONCILIATION What is it? Why is it important? Who does it affect? Medication reconciliation is the process of creating an accurate and updated medication list with information such as drug name, dosage, frequency, and route of administration. Importance: to be able to treat patients effective and achieve better patients outcomes, we must have an accurate and frequently updated patient medications list to make sound clinical recommendation regarding patients therapy. Any gaps in patient’s medications informations may lead to catastrophic outcomes.

OBJECTIVES Create a survey Determine most common problems Design solutions that address problems Implement strategies

PARTICIPANTS Providers (16) CMAs (11) Respondents were from UnityPoint Family Medicine in east Des Moines, Iowa.

STUDY RESOURCES

METHODS Provider participants completed a 5 question survey while CMA participants completed a 9 question survey via email The overarching theme between both surveys was to discover which areas in the med rec process were the most challenging Generally, the questions addressed medication knowledge, provider/CMA confidence, and patient contribution during the process.

RESULTS PRESCRIBER SURVEY

PRESCRIBER SURVEY

PRESCRIBER SURVEY

CMA SURVEY

CMA SURVEY

CMA SURVEY

SURVEY FINDINGS Most providers reported a high frequency of discrepancies between patients home medication list and the reported medication list at their visit. Majority of providers believe there is a need to standardize medication reconciliations. Most providers believe that more medication education to staff and patients would be beneficial

FUTURE DIRECTIONS Standardizing the medication reconciliation process Creation of Collaborative Education Institution course (CEI) Require patient to bring in medications Use of technology that helps patients relay information from one provider to the next.

LIMITATIONS Timeline Email integrity Location of site Limited external validity

CONCLUSIONS Discrepancies in medication records remains a major issue that providers deal with in their everyday practice. Pharmacists are spending more time and more money correcting errors presented in CMAs. This provides us with an opportunity to brainstorm solutions to implement in the near future.

REFERENCES https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3078655/ https://www-ncbi-nlm-nih-gov.proxy.lib.uiowa.edu/pubmed/28039294 https://www.ncbi.nlm.nih.gov/pubmed/14738031 http://www.ihi.org/resources/Pages/Tools/MedicationReconciliationReviewDataCollectionForm.aspx https://www-ncbi-nlm-nih-gov.proxy.lib.uiowa.edu/pubmed/30221857