Beleidskeuzes bij medicatieverificatie door ziekenhuisapotheken

Abstract

Background Medication reconciliation is important to minimize medication errors during transitions in care. However, policies governing its implementation remain unclear. Insight into these policies is important for the implementation of the national medication information transfer program. Objective This study primarily investigates policy decisions regarding the implementation of medication reconciliation in Dutch hospital pharmacies and secondarily assesses the execution of four key steps. Design An observational study was conducted across 21 hospital pharmacies. Methods Data were collected by Master of Pharmacy students using a structured questionnaire. The primary outcome focused on policy decisions, including working days on which medication reconciliation is performed and the validity period of reconciled medication lists. Secondary outcomes evaluated the implementation of the four steps of medication reconciliation: (1) verification to obtain a complete medication list, (2) clarification to optimize this list and eliminate obvious errors, (3) reconciliation to document reasons for medication changes, and (4) transfer to inform the next healthcare provider and patient about the updated list. Descriptive data analysis was used. Results Of 21 hospital pharmacies, 20 performed medication reconciliation at hospital admission, mainly throughout the week (76.2%). 18 hospital pharmacies performed medication reconciliation at discharge, mainly during office hours (42.9%). The validity of reconciled medication lists varied from 24 hours to 6 months. The verification step was always implemented in all pharmacies, while clarification was performed in 57.1%, and the reasons for medication changes were documented in 61.9%. Notably, for the transfer step, in 81.0% of pharmacies, a medication overview - originally intended for communication among healthcare providers - was also provided to patients as part of patient education. Conclusion This study highlights a lack of standardized policy for medication reconciliation. Future studies should explore whether the implementation of the national medication information transfer program affects this variation.