In recent blogs, we've highlighted the importance of effective medication reconciliation, noting that it, along with medication management, can serve as the "foundations for reducing readmissions, cutting unnecessary medical costs, increasing patient safety, and supporting the greater achievement of health goals." If there are any doubts about the value of and need for consistently performing complete and accurate medication reconciliation, we want to help put those to bed. That's why in this piece, we're sharing three medication reconciliation example success stories.
Each of the patients in the following medication reconciliation examples benefitted greatly from having their medication list reconciled by healthcare providers using Cureatr's Meds 360°, a comprehensive medication management and optimization solution that gives healthcare organizations a reliable way to fill in gaps of medication usage for all their patients.
Note: Patient personal health information (PHI) has been deidentified to ensure privacy.
Medication Reconciliation Example #1: Deprescribing Opioid
This patient initially presented with a history of dizziness, imbalance, low blood pressure, falls, and loss of consciousness. Following a visit with a pharmacist and an accompanying review of the patient's medical records, the pharmacist noticed the patient's symptoms worsened after they started taking an opioid in combination with an anxiety medication and seizure medication.
The pharmacist recommended that the patient's neurologist taper down the opioid, but the neurologist chose not to modify the patient's medication regimen. The patient was subsequently admitted to an emergency department twice. During one visit, a hospital practitioner discontinued the opioid. The patient began experiencing reduced dizziness. When the patient next visited their neurologist, the neurologist started the patient on a new medication.
During the patient's next appointment with their primary care provider (PCP), the provider reviewed the patient's medication history in Meds 360°. The platform identified about a dozen potential problems, including several around duplicate drug therapies. When the PCP reviewed the medication reconciliation results with the patient, it was discovered that the neurologist had re-prescribed the opioid. The patient was unaware that the medication had been restarted.
With the reconciled information, the PCP modified the patient's regimen, which included deprescribing the opioid. Had the patient remained on the opioid, there was a high probability that the patient would need to be readmitted yet again to the emergency department.
In addition, the PCP referred the patient to a new pharmacy to receive blister packing to help with medication management and medication adherence.
Medication Reconciliation Example #2: COVID-19 Diagnosis and Adherence Gaps
This patient has a history of hypertension, hyperlipidemia, and idiopathic pulmonary fibrosis. The patient caught COVID-19 from their spouse, which worsened their breathing. The patient experiences shortness of breath often upon walking, climbing stairs, and performing other activities.
After the patient's PCP performed a medication reconciliation using Meds 360°, it was discovered that the patient had adherence gaps in their respiratory and antidepressant medications spanning multiple months. The patient regularly stopped taking their pirfenidone. Over the past year, the patient had visited the emergency department on multiple occasions due to shortness of breath and tightness in their chest.
The patient's PCP coordinated with another provider who conducted a home visit and discovered that the patient had extra medications at home. The patient also has issues with memory, leading to difficulty keeping track of their medications. The PCP put together a list of current medications and medications that the patient should not be taking that will be reviewed during monthly follow-up visits.
In the months that followed, the patient consistently refilled their medications, which the PCP was able to verify through Meds 360°. The patient also had no further visits to the emergency department.
Medication Reconciliation Example #3: Emergency Department Admission Diverted
This older patient has a history of high blood pressure, cellulitis, and glaucoma. They were dealing with what was believed to be a new bout of cellulitis in one of their feet that lasted multiple weeks and experienced worsening symptoms. The patient had seen multiple providers for care.
The PCP reviewed the member's medical history and was unsure whether the patient was dealing with cellulitis or residual chronic vascular insufficiency. Given the patient's age and medical history, the PCP was also concerned about medication adherence.
A review of Meds 360° by the PCP revealed that the patient had been prescribed multiple courses of antibiotic by multiple providers for the cellulitis. The PCP had an extensive discussion with the patient's grandchild, who told the PCP that the patient been admitted to a hospital twice because of these issues. While admitted, the patient underwent vascular studies, which historically produced normal results, and received intravenous antibiotics.
The PCP determined that the medical issue was likely not a recurrent infection that would require an additional emergency department visit. Rather, the PCP was more concerned about a potential chronic venous insufficiency due to the patient's hypertension.. The PCP sent a message to the patient's podiatrist to see if they were willing to see the patient again for a new evaluation or send the patient to a vascular specialist. The PCP also advised the grandchild to reach back out should the patient's symptoms develop again.
The Case for Medication Reconciliation
Every day pro, patients like the three discussed above benefit from the proper completion of medication reconciliation. Just how important is med rec? Let's look at some commentary from experts with firsthand knowledge and experience.
- "Complete and consistent medication reconciliation can foster communication between providers and patients, resulting in strengthened coordination of care, increased patient engagement and satisfaction, and overall improved quality of care." — Girish P. Joshi, MB, BS, MD, FFARCSI, professor of anesthesiology and main management at the University of Texas Southwestern Medical School, via Healthcare Purchasing News
- "Shockingly enough, 60% of hospitalized patients have at least one discrepancy upon admission, and reports exist showing that up to 40% of medication errors are in some way attributable to a lack of proper medication reconciliation." — Nicholas Servati, PharmD, BCCP, clinical pharmacy specialist at UMass Memorial Medical Center, via American Society of Health-System Pharmacists
- "There is no doubt that if you do reconciliation well, there will be fewer adverse drug events, fewer readmissions, and fewer untreated conditions. All of this has an impact on quality and cost. Nobody wants to deliver poor care, and everyone wants to maximize the value they bring to patients." — Steve Meisel, PharmD, CPPS, system director of medication safety for Fairview Health Services/Healtheast Care System, via Institute for Healthcare Improvement
- "Studies have identified medication reconciliation as the most important means of decreasing or eliminating medication discrepancies. Failure to perform medication reconciliation may leave patients and caregivers confused about the proper medications to take at home, which can lead to harmful errors." — Allison (Leverett) Kackman, MN, RN; Cynthia F. Corbett, PhD, RN; Lorna Schumann, PhD, ACNP-BC, NP-C, ACNS-BC, CCRN, ARNP, FNP, ACNP, FAANP; Stephen M. Setter, DVM, PharmD, CGP, via Annals of Long-Term Care: Clinical Care and Aging
- "… medication reconciliation post-discharge (MRP) is vital because the discharge from the hospital to the home is one of the most dangerous care transitions for all patients, but particularly for those with complex medication regimens." — Richard Resnick, CEO of Cureatr, via Cureatr
To find out how Cureatr and Meds 360° is helping healthcare providers nationwide achieve more consistent and accurate medication reconciliation, contact us.