Medication Reconciliation

[stumbleine88]

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I'm wondering what people think about medication reconciliation- whose job/responsibility should this be? I ask because this is a large part of the pharmacist's daily tasks at my current facility, and at my previous work and rotation sites, this was not the case. I can definitely see the value in a pharmacist performing this task over other providers or pharmacy technicians; however, I can't help but be disappointed that "clinical" pharmacists are spending such a large portion of their time and efforts on this! Am I being naive by thinking this is not a clinical pharmacists job and not every task we do is going to be utilizing 100% of our clinical expertise, or have people worked in facilities where this is the responsibility of the physician, nurse, or the health care team collectively?

 

[Sparda29]

There was a hospital pharmacist job that I applied for that was listed as "Medication Reconciliation Pharmacist".

 

[bacillus1]

On admission, I haven't made up my mind yet. I think pharmacy students could do it. Heck, PAs could do it (they earn less money than pharmacists, so why not put them to work). There's definitely value in pharmacists doing it though, and if a facility wants to spend money on that, it should go for it.

On discharge, definitely a pharmacist. The staffing component of my residency is discharge planning. I basically compare patients' inpatient meds to outpatient meds, then call doctors with lots of questions about the meds because a lot of times the discharge orders are missing something or aren't right, and finally counsel the patients on their new meds before they leave the hospital. I think that is definitely something that pharmacists should do. Too bad the process in my hospital is pretty inefficient, with doctors constantly changing their minds on whom they want to discharge.

 

[glory4england]

I'm a P4 currently doing my rotations. I have done an Emergency Medicine rotation and shadowed a few pharmacists in the ED at various rotations and this is what I noticed:

At one site with a ED pharmacist on staff 24/7 the pharmacists are responsible for medication reconciliations. However they only reconcile the medications of patients being admitted to the hospital and patients with chronic conditions.

At another site with ED coverage 9a-5p on weekdays with 2 pharmacists the nursing staff is responsible for all medication reconciliations.

Another site actually had a pharmacy technician dedicated to doing medication reconciliation. The pharmacy technician would talk to the patients and write a report for the pharmacist to enter into the system. This is when the pharmacist would have a chance to look for duplicated therapy, drug interactions, etc.

I think that pharmacists should definitely play a role in medication reconciliation (especially at discharge and for admitting patients). But I am not sure if its possible to have pharmacists doing med rec for all patients.

 

[WVUPharm2007]

As long as it isn't me, I don't care.

Med rec sheet is a dirty word, indicative of great suffering and nausea, in my universe. Like root canal...or Hitler...one of those words.