Development and Evaluation of Inpatient Medication Reconciliation Process at Mahasarakham Hospital

Abstract

Objective : To assess the medication reconciliation (MR) process in the inpatient department at Mahasarakham Hospital.

Methods : This retrospective operational research collected data and recorded medical errors from prescriptions for the chronically ill. The study was divided into two phases: 1) Phase I, conducted from 1st October 2020 to 30th September 2021, and 2) Phase II, conducted from 1st October 2021 to 31st March 2024. Descriptive statistics and Fisher’s exact test were used to compare the data across each research period.

Results : The percentage of actions following MR guidelines within 24 hours increased from 69.10% to 78.03%. There were 443 instances of medical errors (ME). Potential harm at the B level decreased from 161 instances per year to 101.20 instances per year, and actual harm at the C level decreased from 11 instances per year to 7.20 instances per year. Moreover, the severity of harm decreased from F level to C level. If unresolved, potential harm levels were predicted to occur at the C–D level in 75% of cases and at the E–G level in 25% of cases. The most frequent errors included wrong-dose or wrong-frequency errors, omission errors, untaken-drug-order errors, and wrong-drug errors. The most frequently implicated medicines in ME were warfarin, anti-diabetes drugs, and anti-hypertensive drugs. The total relative weight of the Potential Drug Therapy Problem was 2,900 points, with a quality score of 6.54. The cost savings from inhalers and insulin injections in Phase II totaled 1,070,958.0 baht.

Conclusion : Medication reconciliation (MR) enables a decrease in medical errors, harm levels, and drug costs. Further development of post-operative and discharge procedures is recommended.