Pharmacist Discharge Medication Reconciliation Study

Alberta Health services50 enrolled

Overview

Adverse drug events can occur commonly due to medication errors during the transition of care in a health care facility. Medication reconciliation is the process of comparing medications and providing an accurate medication list as a resource for prescribers, which is currently only being done upon inpatient admission at the CCI. The purpose of this study is to see if pharmacist medication reconciliation at discharge reduces unintentional medication discrepancies for inpatient discharges.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Medication Reconciliation

Interventions

MRSPROCEDURE

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Cancer inpatients under the care of Dr. Follett or Dr. Candler * Cancer inpatients to be discharged from the CCI * Patients \>18 years of age * Patients that are taking \>1 medications or herbals total at home. Exclusion Criteria: * Cancer inpatients that are considered radioactive or in "hot rooms" (ie. Selectron patients or patients receiving radiation treatment for thyroid) * Patients that do not remain in hospital \>72 hours * Patients without a home phone number or equivalent contact number. * Language barrier (patients unable to speak or understand English). * Patients that are readmitted and already included into the study.

Locations (1)

Cross Cancer Institute

Edmonton, Alberta, Canada

Outcomes

Primary Outcomes

MRS Correlation with Treatment Response.

The percentage of patients with at least one unintentional medication discrepancy after discharge from the Cross Cancer Institute

Time frame: up to 1 year

Secondary Outcomes

Correlation with Tumor Stage

The amount of medication discrepancies after discharge that has the potential to cause moderate harm to severe harm.

Time frame: up to 1 year

The frequency of each type of unintentional medication discrepancies.

Data from ClinicalTrials.gov

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