Effect of Medication Reconciliation on Hospitalized Asthmatic Patients

Abstract

Background: Medication reconciliation of the inhaler has been studied mostly among the special technique dosage forms due to complicated method of use, and patients’ not bringing inhaler with them during hospital visit.

Objectives: To assess the medication error and inhaler cost savings in case of pharmacists providing medication reconciliation, to explore the output of medication reconciliation services and to study the satisfaction to the pharmaceutical care services.

Method: A mixed-methods study was conducted on asthmatic in-patients of Warinchamrab hospital during October 2023 to February 2024. A purposive sample of 39 patients was recruited. Medication reconciliation, screening for medication error and determination of inhaler cost saving were conducted. The outcome of medication reconciliation, and the reason for hospital visit were studied.

Results: The main medication errors both at admission and at discharge were administration error and prescribing errors, respectively. Medication errors were detected more as pharmacist participated in the ward comparing to the traditional pharmacist services. Pharmacist participated in medication reconciliation could save the cost of inhaler up to 19,109 Baht. The 94.9% of cases could complete the medication reconciliation within 24 hours, by which the doctor prescribed the same medication as previous 76.9%. The transportation cost for a one-way trip to the hospital was 102.36±76.52 Baht/visit. The 48.7% of patients did not bring their usual medication to the hospital, because of emergency visit, unexpected admission, and never receiving suggestion to bring along the medication. Patients sought additional advice on using of inhaler alongside with nebulizer, and wanted to know the available doses of each type of inhaler.

Conclusion: The involvement of pharmacist in the ward increased the detection and resolving of the medication errors. The percentage of case receiving medication reconciliation within 24 hours were achieved as the target of the hospital. Patient feedback has led in improvements to inhaler labeling.