Abstract

Medication reconciliation is a system for identifying drug discrepancies at different point of transition to prevent medication errors and adverse drug events. This study aimed to identify discrepancies in patients receiving and not receiving medication reconciliation, and to evaluate the effectiveness of medication reconciliation process. This was an observational cohort study. Patients who transferred from emergency room to pediatric and internal wards Dr. Margono Soekarjo Hospital (n=224) were arbitrarily grouped to 1) patients receiving medication reconciliation, and 2) not receiving medication reconciliation. Both groups were followed to compare medication data and reconciliation process. The result showed that 185 discrepancies were found in 139 (62%) patients who received reconciliation. Of these, 78% discrepancies were resolved by reconciliation. Meanwhile, there were found 140 discrepancies in 85 (37.9%) patients who did not receive reconciliation. All of it could not be resolved. There was significant difference of discrepancies (p

Key words: medication reconciliation, discrepancy, pharmacist, hospital