Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Sep;25(5):245-250.
doi: 10.1136/ejhpharm-2017-001441. Epub 2018 Feb 8.

Electronic medication reconciliation in hospitals: a systematic review and meta-analysis

Hongmei Wang  1 , Long Meng  1 , Jie Song  1 , Jiadan Yang  1 , Juan Li  1 , Feng Qiu  1
Affiliations

Electronic medication reconciliation in hospitals: a systematic review and meta-analysis

Hongmei Wang et al. Eur J Hosp Pharm. 2018 Sep.

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.

Keywords: electronic tools; medication reconciliation; medication safety; meta-analysis; unintended discrepancies.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow diagram of the study selection process.
Figure 2
Figure 2
Meta-analysis of the proportion of medications with unintended discrepancies.
Figure 3
Figure 3
Meta-analysis of the proportion of patients with unintended medication discrepancies.
Figure 4
Figure 4
Meta-analysis of the proportion of omission errors compared with the total number of medications.
See this image and copyright information in PMC

References

    1. U.S. Food and Drug Administration. Strategies to reduce medication errors: working to improve medication Safety. http://www.fda.gov/drugs/resourcesforyou/consumers/ucm143553.htm (accessed 16 Sep 2017).
    1. World Health Organization. WHO global patient safety challenge - medication safety. http://www.who.int/patientsafety/campaigns/en/ (accessed 16 Sep 2017).
    1. The Joint Commission. National Patient Safety Goals (NPSGs). 2017. https://www.jointcommission.org/standards_information/npsgs.aspx (accessed 16 Sep 2017).
    1. The Joint Commission. Using medication reconciliation to prevent errors. Jt Comm J Qual Patient Saf 2006;32:230–2. - PubMed
    1. Institute for Healthcare Improvement. Medication reconciliation review. http://www.ihi.org/resources/Pages/Tools/MedicationReconciliationReview.... (accessed 16 Sep 2017).

Publication types