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The results suggest that resident input in the implementation of medication reconciliation interventions is essential to ensure the success of the program.
A systematic review suggests that the most effective medication reconciliation interventions are those that utilize pharmacy staff and focus on patients at high risk for adverse events [ 6].
The toolkit components were informed by a systematic review of medication reconciliation interventions, [ 12] the AHRQ-funded conference of stakeholders,[ 16] and the work of the MARQUIS investigators and advisory board.
Furthermore, the implementation of medication reconciliation interventions varies widely across hospitals, and hospitals need clearer guidance on which interventions are more likely to be successful in their local environment [ 15].
When tested, hospital-based medication reconciliation interventions have consistently demonstrated reductions in medication discrepancies, though effects on more distal outcomes such as readmission have been less consistent and limited by study size [ 12, 13].
In comparison, in prior studies by Schnipper et al. potentially harmful medication discrepancies began at 1.44 per patient, then decreased to 1.05 and then 0.32 per patient with successive versions of medication reconciliation interventions [ 27, 35].
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12 13 A UK-based study concluded that pharmacist-led medication reconciliation intervention had the highest expected net benefit compared to nurse-led and physician-led interventions.
Although studies to date have not shown a consistent effect, this may be because of the design of the medication reconciliation intervention studied or because other factors had greater influence on hospital utilization [ 6].
Varying success was achieved with medication reconciliation education interventions.
3. Assess the effects of medication reconciliation QI interventions on unintentional medication discrepancies with potential for patient harm.
The objective of this systematic review is to identify studies, of any type, reporting on educational interventions aimed at improving the knowledge and skill of medical trainees (i.e. medical students, residents) in carrying out effective medication reconciliation, and to determine which educational interventions are most effective.
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