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Evaluation of the impact of pharmacist-led medication reconciliation intervention: a single centre pre–post study from Ethiopia

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Abstract

Background The role of pharmacists in medication reconciliation (MedRec) is highly acknowledged in many developed nations. However, the impact of this strategy has not been well researched in low-and-middle-income countries, including Ethiopia. Objective The aim of this study was to investigate the impact of pharmacist-led MedRec intervention on the incidence of unintentional medication discrepancies in Ethiopia. Setting Emergency department in a tertiary care teaching hospital in Ethiopia. Method A single centre, prospective, pre-post study was conducted on adults (aged 18 years or over) that had been hospitalized for at least 24 h and were taking at least 2 home medications on admission. The intervention involved assignment of a pharmacist to an emergency care team so as to take the best possible medication history and reconcile this list with the current medications in use. Main outcome measure Incidence and potential clinical severity of unintentional medication discrepancies. Results 123 patients were included (pre-intervention, 49; post-intervention, 74). The proportion of patients with at least one unintended discrepancy was reduced from 59 to 10.5% after the intervention (p < 0.001). Similarly, the percentage of patients with potentially severe clinical impact medication discrepancies reduced significantly after the intervention (p < 0.01). Most importantly, the likelihood of occurrence of unintentional medication discrepancies was approximately 17 times more often in the absence of pharmacist intervention (OR 16.45, 95% CI 5.22, 51.85). Conclusion This study has found that pharmacist-led MedRec intervention was impactful, and it was able to minimize the incidence of unintentional medication discrepancies significantly.

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Acknowledgements

The authors would like to thank the pharmacists Abaynesh Fentahun, Melka Abdisa, Tamerat Befekadu for their help for the collection and categorization of data, all staffs at the emergency ward and the pharmacist (Feser Dula) who was member of the emergency ward team. The contribution of Misganaw Semagn, focal personnel for drug information service, is highly acknowledged. The technical support from the clinical director of Gondar University Hospital, and other departments (Internal medicine and Hospital pharmacy) are gratefully acknowledged. Alemayehu B Mekonnen gratefully acknowledge funding to support his Ph.D. training provided by The University of Sydney International Students’ Scholarship.

Funding

This study was partly funded by the University of Sydney through the Postgraduate Research Support Scheme (PRSS).

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Authors and Affiliations

  1. Faculty of Pharmacy, The University of Sydney, A15 Pharmacy and Bank Building, Sydney, NSW, 2006, Australia

    Alemayehu B. Mekonnen, Andrew J. McLachlan & Jo-anne E. Brien

  2. Centre for Education and Research on Ageing, Concord Hospital, Sydney, Australia

    Andrew J. McLachlan

  3. St Vincent’s Hospital Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia

    Jo-anne E. Brien

  4. Department of Internal Medicine, Addis Ababa University, Addis Ababa, Ethiopia

    Desalew Mekonnen

  5. Department of Internal Medicine, University of Gondar, Gondar, Ethiopia

    Zenahbezu Abay

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  1. Alemayehu B. Mekonnen
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Correspondence to Alemayehu B. Mekonnen.

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Mekonnen, A.B., McLachlan, A.J., Brien, Ja.E. et al. Evaluation of the impact of pharmacist-led medication reconciliation intervention: a single centre pre–post study from Ethiopia. Int J Clin Pharm 40, 1209–1216 (2018). https://doi.org/10.1007/s11096-018-0722-9

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