The Effect of Pharmacy-Led Medication Reconciliation on Odds of Psychiatric Relapse at a Community Hospital

• Published in: Journal of pharmacy practice Vol. 37; no. 2; p. 391
• Main Authors: Light, Jamie, Ruh, Christine, Ott, Michael, Banker, Christopher, Meaney, Drake, Doloresco, Fred, Noyes, Katia
• Format: Journal Article
• Language: English
• Published: United States 01.04.2024
• Subjects: transitions of care; drug information; pharmacy administration; pharmacy education
• ISSN: 1531-1937
• DOI: 10.1177/08971900221137100

Individuals with psychiatric disorders are at increased risk for treatment non-adherence and related complications, especially during transitions of care. Medication reconciliation is now a standard process during hospital admissions that is uniformly recommended by international organizations to aid in safe and effective care transitions. Pharmacy-led medication reconciliation (PMR) practices are poised to represent a standardized method of reconciliation attempt within this underserved population with complex medication histories. A retrospective cross-sectional study using medical chart review was conducted for all adults admitted to the inpatient psychiatric service at a community hospital in Buffalo, NY, during 2 months in 2018. Outcomes were 30- and 180-day psychiatric readmission rates, 30- and 180-day visit rates to the outpatient comprehensive psychiatric emergency program (CPEP), and composite 30- and 180-day relapse. Receipt of pharmacy-led medication reconciliation was identified from pharmacy documentation in the electronic medical record. 78% of patient's medication lists on admission were reconciled, with 49% of reconciliations made by the inpatient pharmacy. Presence of a PMR did not alter the odds of inpatient readmission alone, however patients without a PMR were found to have 2.13 times higher odds of visiting the hospital's outpatient CPEP within 30-days ( = .012) and 1.9 times higher odds of any composite psychiatric relapse within 30-days ( = .024). Implementation of hospital-wide pharmacy-led medication reconciliation on admission may help reduce psychiatric relapse across multiple care settings.