OBJECTIVE To determine whether specific design interventions (changes in the user interface (UI)) of an electronic health record (EHR) medication module are associated with an increase or decrease in the incidence of contradictions between the structured and narrative components of electronic prescriptions (internal prescription discrepancies). MATERIALS AND METHODS We performed a retrospecti...

OBJECTIVE Patients with attention deficit hyperactivity disorder (ADHD) and a medication history have shown abnormal brain activation in prefrontal and striatal brain regions during cognitive challenge. Previous findings have been confounded, however, by potential long-term effects of stimulant medication exposure and group discrepancies in task performance. The aim of this study was to investi...

Background: Transitional care programs are a growing topic in health care systems across the country, with a focus on achieving a reduction in hospital readmissions and improving patient and medication safety. Numerous strategies have been employed and studied to determine successful approaches to patient transition from the hospital setting to the home setting. Pharmacist-mediated postdischarg...

OBJECTIVES To identify and resolve discrepancies between the medications prescribed when patients are admitted to hospital and the medication usually taken by selected patients, adapting the prescriptions to the pharmacotherapeutic guidelines and the clinical con- dition of the patient. METHOD A prospective study in which patients over the age of 65 with at least one chronic disease in additi...

OBJECTIVES To investigate the effect of pharmacy-based medication reconciliation on the frequency of unintentional medication discrepancies in acutely admitted individuals aged 65 and older. DESIGN Multicenter intervention study with pre-post design. SETTING Twelve Dutch hospitals. PARTICIPANTS One thousand five hundred forty-three individuals aged 65 and older with an acute hospital admi...

OBJECTIVES Transitions in patient care pose an increased risk to patient safety. One way to reduce this risk is to ensure accurate medication reconciliation during the transition. Here we present an evaluation of an electronic medication reconciliation module we developed to reduce the transition risk in patients referred for home healthcare. METHODS Nineteen physicians with experience in man...

BACKGROUND Medication reconciliation at transitions in care is a national patient safety goal, but its effects on important patient outcomes require further evaluation. We sought to measure the impact of an information technology-based medication reconciliation intervention on medication discrepancies with potential for harm (potential adverse drug events [PADEs]). METHODS We performed a cont...

Background: To prevent adverse drug events and promote patient safety, medication reconciliation is critical in all patient care settings. The purpose of this study was to identify medication discrepancies occurring in an inpatient medicine unit and to analyze the clinical and economic benefit of clinical pharmacist and physician team collaboration. Methods: A prospective cohort study in which ...

INTRODUCTION Comorbidities and polypharmacy complicate the treatment of geriatric patients with acute orthopedic injuries. A correct medication history and an updated medication list are a prerequisite for safe treatment of these debilitated patients. Published evidence suggests favorable outcomes with comanaged care. The aim of this study was to assess the accuracy of the inpatient medication ...