Medication Histories Conducted by Nurses (RNs), Pharmacy Techs (CPhTs) & Pharmacists (RPhs)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01065675
Recruitment Status : Terminated (Statistical analysis of 153 enrolled Phase 1 patients showed that specific patients could not be targeted for medication histories by discipline.)
First Posted : February 9, 2010
Last Update Posted : December 28, 2012
Cardinal Health Foundation
Information provided by (Responsible Party):
Joan Kramer, Wesley Medical Center

Brief Summary:

Up to 50% of medication errors and 20% of adverse drug reactions (ADRs) in the hospital setting are estimated to be related to communication issues regarding patient medications at various transition points of care from admission to discharge. The Joint Commission (TJC) requires accurate and complete medication reconciliation occur at each transition point throughout hospitalization. Evidence from NQF demonstrates pharmacists (RPh) are the most effective medication management team leaders in the implementation of medication management practices and design of medication error reduction strategies; medication reconciliation is one of the five safety objectives pharmacists are recommended to lead. In addition, the Massachusetts Coalition for the Prevention of Medical Errors states strong evidence supports the use of pharmacy technicians (CPhT) in conjunction with pharmacists in completing accurate medication histories.

WMC nurses (RN) currently are involved in the medication reconciliation process. In 2009, a Medication Use Evaluation (MUE) of Medication Reconciliation Accuracy found a 67% medication error rate on admission determined by comparing the nurse-obtained medication history to the pharmacist-obtained medication history. The number of home medications identified by the pharmacist compared to the nurse was 411 versus 312 (p<0.0001). The total percentage of medication errors prevented by the pharmacist was 66.2. Using the VA Healthcare Failure Mode Effects Analysis - HFMEA™ Hazard Scoring Matrix, 3 independent pharmacist reviewers found that 18% of patients interviewed had a score greater than 7, and 3 patients had a score of 12 (major/probable), if the discrepancies would not have been identified and corrected by the pharmacist conducting the admission medication reconciliation audit. The same patients' discharge medication reconciliation and discharge medication lists were retrospectively reviewed for the MUE, and the total percentage of patients with medication errors on discharge was 43%.

Condition or disease Intervention/treatment Phase
Medication Reconciliation Emergency Department Other: Medication reconciliation completed by a RN, CPhT, or RPh Not Applicable

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 153 participants
Intervention Model: Single Group Assignment
Masking: Single (Care Provider)
Primary Purpose: Health Services Research
Official Title: Electronic Patient Triage Development and Implementation Involving Nurse (RN), Pharmacy Technician (CPhT), and Pharmacist (RPh) Obtained Medication Histories in the Emergency Department (ED)and Impact on Medication Reconciliation
Study Start Date : February 2010
Actual Primary Completion Date : April 2010
Actual Study Completion Date : May 2011

Intervention Details:
    Other: Medication reconciliation completed by a RN, CPhT, or RPh
    To determine which patients benefit the most from medication histories obtained by the RN, CPhT, or RPh. Patients will be admitted as inpatients through the ED with medication histories finalized electronically by the RN at the admitting unit.
    Other Names:
    • Medication Reconciliation
    • Pharmacist
    • Nurse
    • Certified Pharmacy Technician
    • Emergency Department
    • ED

Primary Outcome Measures :
  1. To determine which patients benefit most from medication histories obtained by the RN, CPhT, or RPh based on accuracy (% complete disease states, allergy documentation and description, vaccination documentation, medication documentation) [ Time Frame: 5 months ]

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

Ages Eligible for Study:   Child, Adult, Senior
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patients admitted as inpatients from the Emergency Department

Exclusion Criteria:

  • Prisoners (because the IRB does not have a prisoner representative)
  • Patients not admitted as inpatients through the Emergency Department
  • Patients admitted more than once during the study period

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01065675

United States, Kansas
Wesley Medical Center
Wichita, Kansas, United States, 67214
Sponsors and Collaborators
Wesley Medical Center
Cardinal Health Foundation
Principal Investigator: Joan S Kramer, PharmD Wesley Medical Center

Responsible Party: Joan Kramer, Clinical Research Pharmacist, Wesley Medical Center Identifier: NCT01065675     History of Changes
Other Study ID Numbers: 09-068
First Posted: February 9, 2010    Key Record Dates
Last Update Posted: December 28, 2012
Last Verified: December 2012

Keywords provided by Joan Kramer, Wesley Medical Center:
Medication Reconciliation
Emergency Department
Certified Pharmacy Technician
Medication reconciliation: inpatients admitted from the ED

Additional relevant MeSH terms:
Disease Attributes
Pathologic Processes