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Table 1 Characteristics of included studies

From: Impact of electronic medication reconciliation interventions on medication discrepancies at hospital transitions: a systematic review and meta-analysis

Author, Year Country, Setting Study design Participant size Target of transition Components of intervention Length of study Medications assessed Verification of discrepancy Main results
Agrawal 2009 [35] USA, Tertiary care academic hospital Pre-post 19,476 patients Admission Multidisciplinary admission medication reconciliation, computerized reminder alert 17 ½ months Prescription and non-prescription medications Yes At least 1 unintended discrepancy: 20 % (Pre) vs. 1.4 % (Post)
Drug omission was the most common type of discrepancy in both phases
Allison 2015 [36] USA, Academic tertiary care facility Pre-post 200 patients Discharge Electronic discharge medication reconciliation, staff training NR Antibiotics Yes At least 1 antibiotic error: 23 % (Pre) vs. 11 % (Post)
Percentage of medications with errors: 30 % (Pre) vs. 15 % (Post)
Dosage errors were the most common type of medication error in both phases
Boockvar 2010 [37] USA, Three academic centers NRCT 469 patients Nursing home to hospital transfer (admission) Structured review NR Prescription medications Yes No difference, with and without EHR, in medication discrepancies (mean difference 0.02; 95 % CI - 0.81 to 0.85) and a high-risk discrepancies (mean difference −0.18; 95 % CI −0.22 to 0.58) per hospitalization episode, and an ADE caused by a medication discrepancy (OR 0.96; 95 % CI 0.18 to 5.01)
46 % of prescribing discrepancies resulted in ADEs were due to drug omissions
Gimeneze- Manzorro 2011 [42] Spain, Tertiary care hospital Pre-post 3,781 medications Admission Computerized reconciliation tool integrated in a CPOE program 6 months NR Yes Percentage of medications with discrepancies: 7.24 % (Pre) vs. 4.18 % (Post)
Drug omission was the most frequent unintended discrepancy in both phases
Omission errors: 5.8 % (Pre) vs. 3.4 % (Post)
Gimeneze- Manzorro 2015 [43] Spain, University general hospital Pre-post 191 patients Admission Nurses gather BPMH via an electronic reconciliation tool, use of CPOE 6 months Prescription medications Yes At least 1 unintended discrepancy: 40.2 % (Pre) vs. 38.1 % (Post)
Medications with unintended discrepancies: 10.6 % (Pre) vs. 6.6 % (Post)
Of all unintended discrepancies, 144 (86.2 %) were due to drug omissions
Omission errors: 9.2 % (Pre) vs. 5.6 % (Post)
Kramer 2007 [38] USA, General medical unit Pre-post 283 patients Admission, discharge Pharmacists and nurses collaborated to electronically complete admission and discharge medication reconciliation, discharge medication counselling 13 months Prescription, non-prescription and herbal supplements No Post-implementation, patients took significantly more prescription and nonprescription medications.
Murphy 2009 [39] USA, Academic medical center Pre-post SU, 149 discharges; MU, 134 discharges Admission, discharge Multidisciplinary MedRec using an electronic tool 2 ½ months Prescription and non-prescription medications Yes Percentage of medications with unintended discrepancies: 90 % (Pre) vs. 47 % (Post) [SU]; 57 % (Pre) vs. 33 % (Post) [MU]
On the surgical unit, omitted home medications (reduced from 21 % of orders to 0 %), omitted inpatient medications (from 8 to 1 %) and in the medical unit, omitted home and inpatient medications were both reduced from 11 to 0 %.
Schnipper 2009 [40] USA, Two academic hospitals RCT 322 patients Admission, discharge IT designed MedRec integrated into the CPOE system, interdisciplinary medication reconciliation intervention comprising novel IT and process re-design, supportive roles (e.g. training) NR NR Yes Mean number of medication discrepancies with a potential for harm per patient: 1.44 (C) vs. 1.05 (I) [RR 0.72 (0.52–0.99)]
Poole 2006 [41] USA, Community hospital Pre-post 100 patients Discharge Formation of a medication list from pre-existing electronic sources and reconciliation of discharge medications with this list 6 months prescription medications Yes Statistically significant improvement with intervention vs. control in at least 1 outcome in this category; i.e., drug frequency, dose and therapeutic duplication
Resolution of discrepancies in frequency increased by 65 %
Resolution of discrepancies in dosages improved by 60 %
Resolution of therapeutic duplication was addressed in 58 % of cases
Zoni 2012 [44] Spain, University general hospital Pre-post 162 patients Admission IT-designed MedRec, clinical sessions and training 12 months Regular medications, OTC and homeopathic products Yes Percentage of medications with unintended discrepancies:3.5 % (Pre) vs. 1.8 % (Post)
At least 1 unintended discrepancy: 23.7 % (Pre) vs. 14.6 % (Post)
Drug omission was the most common unintended discrepancy
Omission error: 2.6 % (Post) vs. 2 % (Pre)
  1. ADE adverse drug event, BPMH best possible medication history, CPOE computerized physician order entry, C control, EHR electronic health record, I intervention, IT information technology, MedRec medication reconciliation, MU medical unit, NR not reported, OR odds ratio, OTC over-the-counter, Pre pre-implementation, Post post-implementation, RCT randomized controlled trial, RR relative risk, SU surgical unit