Work

Can nonclinicians classify medication discrepancies as accurately as clinical pharmacists? A validation study

Year: 2022

Type: article

Abstract: Medication discrepancies, defined as unintended differences between medication lists, 1 occur in up to 60% of patients' electronic health records (EHRs).[2][3][4] They are associated with adverse drug events and increased healthcare utilization [5][6][7][8] ; thus, the Joint Commission recommends medication reconciliation to resolve discrepancies between patient-reported medications and those documented within the record. 9 Medication reconciliation tools to identify and correct discrepancies can provide patient safety and cost-related benefits.7 Discrepancy types within classification systems differ, but common types include Commission (i.e., medication present in EHR but patient not taking), Omission (i.e., medication absent from EHR), and Drugdose (i.e., dose missing or incorrect).10 The Medication Discrepancy Taxonomy (MedTax) is a universal classification system developed to advance research and evaluations to reduce discrepancies. 1 MedTax was designed and validated for use by pharmacists only.Exclusively relying on pharmacists' or clinicians' expertise to classify medication discrepancies may be limited by costs and time availability.Using nonclinicians in medication reconciliation processes could provide many benefits, especially in research and quality improvement (QI) initiatives.However, little is known about the role of nonclinical personnel in the classification subprocess.We determined if research assistants (RAs) without formal clinical education can classify identified medication discrepancies with accuracy comparable to pharmacists. | METHODS | DatasetA dataset containing 1024 discrepancies (e.g., omissions, commissions) was derived from medication lists of 179 patients (5.7 discrepancies/patient) collected during care transitions as part of a larger trial from December 2019 to October 2020.11 All study procedures were approved by the VA Boston Healthcare System Institutional Review Board.

Source: Health Science Reports

DOI: 10.1002/hsr2.824

Authors: Julianne E. Brady, Steven R. Simon, Kate Yeksigian, Alan J. Zillich, Jonathan Moyer, Amy M. Linsky