AHRQ Patient Safety Network - Patient Safety Primers

Patient Safety Primer What are Patient Safety Primers?
Medication Reconciliation


Background

Patients admitted to a hospital commonly receive new medications or have changes made to their existing medications. As a result, the new medication regimen prescribed at the time of discharge may inadvertently omit needed medications that patients have been receiving for some time. Alternatively, new medications may unintentionally duplicate existing medications. For example, a physician might prescribe a calcium channel blocker to a patient who has hypertension but is already taking another medication from the same drug class.

Such unintended inconsistencies in medication regimens may occur at any point of transition in care (eg, transfer from an intensive care unit to a general ward), not just at hospital admission or discharge. Studies have shown that unintended changes in medications occur in 33% of patients at the time of transfer from one site of care within a hospital, and in 14% of patients at hospital discharge. Medication reconciliation refers to the process of avoiding such inadvertent inconsistencies across transitions in care by reviewing the patient's complete medication regimen at the time of admission, transfer, and discharge and comparing it with the regimen being considered for the new setting of care.

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AHRQ Patient Safety Network - Patient Safety Primers