Medication Reconciliation: Just Because It's Done Doesn't Mean It's Done Right

Medication reconciliation between admission and discharge prescriptions is meant to ensure that medications are not discontinued inadvertently, retained inappropriately, or prescribed incorrectly during transition of care. Another concern is patient awareness and understanding of medication changes.

Researchers at Yale prospectively studied medication reconciliation in 377 discharged patients (age, >64) following admission for acute coronary syndrome, pneumonia, or heart failure. Accuracy of medication reconciliation was determined by comparing written admission and electronic discharge medication lists and auditing charts. One week after discharge, patients were interviewed by telephone and queried about whether changes to their admission r…