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- Page navigation anchor for Are we legitimately stopping medications? Use of pharmacist and junior doctor teaching to improve medication reconciliationAre we legitimately stopping medications? Use of pharmacist and junior doctor teaching to improve medication reconciliation
Following the previous study on adverse drug reaction documentation in hospital,1 I conducted a study that investigated medication reconciliation between hospital and primary care. A previous study reported that long-term medications were stopped 11.4% of the time after an overnight hospitalization for elective surgical procedures, versus 4.8% after no procedures.2 These discontinuation were potentially unintended. When documentations are lacking, it is difficult for primary care doctors to justify whether a drug is discontinued for a valid reason.
The current study aimed to identify how often medications were stopped without clinicians’ signatures and documented indications. It also aimed to determine whether pharmacist and junior doctor teaching can improve medication reconciliation. The current study consisted of two retrospective reviews of patients’ paper drug charts and case notes, conducted about three months apart in two surgical wards in Royal Lancaster Infirmary. A junior doctor, who used to work as a pharmacist, discussed the initial review results with the foundation year and surgical doctors, and taught ways to improve documentation in two educational meetings. The meetings reminded doctors to sign on the drug charts when stopping medications, encouraged doctors to document why medications are started and stopped, and described some of the problems experienced when the documentations are inadequate. The results i...
Competing Interests: None declared.