Abstract
Aims
The aim of this study was to improve medication reconciliation and reduce the occurrence of duplicate prescriptions by pharmacists and physicians within 72 hours of hospital admission using an intelligent prescription system combined with the National Health Insurance PharmaCloud system to integrate the database with the medical institution computerized physician order entry (CPOE) system.
Methods
This 2‐year intervention study was implemented in the geriatric ward of a hospital in Taiwan. We developed an integrated CPOE system linked with the PharmaCloud database and established an electronic platform for coordinated communication with all healthcare professionals. Patients provided written informed consent to access their PharmaCloud records. We compared the intervention effectiveness within 72 hours of admission for improvement in pharmacist medication reconciliation, increased at‐home medications documentation and decreased costs from duplicated at‐home prescriptions.
Results
The medication reconciliation rate within 72 hours of admission increased from 44.0% preintervention to 86.8% postintervention (relative risk = 1.97, 95% confidence interval [CI]: 1.69–2.31; P < .001). The monthly average of patients who brought and took home medications documented in the CPOE system during hospitalization increased by 7.54 (95% CI 5.58–20.49, P = .22). The monthly average of home medications documented increased by 102.52 (95% CI 38.44–166.60; P = .01). Savings on the monthly average prescription expenditures of at‐home medication increased by US$ 2,795.52 (95% CI US$1310.41–4280.63; P < .01).
Conclusion
Integrating medication data from PharmaCloud to the hospital's medical chart system improved pharmacist medication reconciliation, which decreased duplicated medications and reduced in‐hospital medication costs.
Keywords: clinical pharmacy, elderly, medication safety, patient safety, quality use of medicines
What is already known about this subject
Older patients often visit doctors in multiple hospitals and possibly receive duplicate medication treatments for the same diseases, which causes increased medication expenditure and potential adverse events in hospital patients.
PharmaCloud, an online database, can assist with medication reconciliation; however, data about its use at admission in Taiwan are lacking.
What this study adds
This intervention study examined integrating PharmaCloud with computerized physician order entry for medication reconciliation by a pharmacist at admission using pre/post data.
Rates of implementing medication reconciliation increased from 44.0% to 86.8% after integrating PharmaCloud with computerized physician order entry.
Savings from reducing duplicated medication increased from $2799 to $5594.7 (US) monthly.
1. INTRODUCTION
Medication reconciliation should be implemented during patient admission, transfer and discharge to reduce medication errors, decrease avoidable morbidity and improve patient safety.1 Patients, especially the elderly, might not regularly seek care at the same facility, which could result in taking duplicate or inappropriate medications.2 Elderly patients may practice hospital shopping behaviour, which results in repeatedly visiting hospitals for the same disease, and for the same medications with the same pharmacological classification.3 These patients are more likely to receive duplicate medications, which increases the risk of adverse drug effects. The duplication rate of medications was estimated at 43.5% in Taiwan.4
To provide good medication quality and help physicians and pharmacists ensure patients' medication safety, Taiwan's National Health Insurance Administration (NHIA) adopted cloud technology in July 2013 to set up the patient‐centred NHI PharmaCloud System. This system links a list of patients' prescribed and dispensed medication records over the previous 3 months from different hospitals, clinics and pharmacies for all insured patients, and can provide healthcare professionals with the medication history of patients that includes prescriptions from all hospitals or clinics, with coverage of inpatient care and ambulatory care.5 To protect patient privacy, we need to use both patients' NHI smart identification card and healthcare professionals' NHI identification card to connect with the PharmaCloud system when physicians or pharmacists access patients' medication list in the PharmaCloud database. Patients sign the PharmaCloud consent form allowing their physicians to access their medication history in the PharmaCloud. After we have obtained patients' informed consent, NHI can authorize daily download of real‐time medication records from the NHI PharmaCloud system into the hospital's database.6 If patients have cognitive impairments (e.g. children, dementia etc.), legal guardians could consent to access to their medical records. Utilizing the PharmaCloud system could decrease medication duplication and the potential cost containment could reach 2–5% of total medication expenditures.7 According to NHIA statistics, rates of cross‐hospital duplicate medication, including hypotensors, hypolipidaemics, hypoglycaemics, medication for schizophrenia, antidepressants and hypnotic tranquilizers, were reduced by 30–50% from 2014, after implementing the PharmaCloud system. It is estimated that around US $335 million (NT $10.4 billion) in medication expenditures has been saved in 2015.8
Due to the global medical challenge of ageing, it is vital to reduce duplication of medications across medical institutions, especially in treating the elderly. The goal of medication reconciliation is to obtain accurate and complete medication information and use it to ensure safe and effective medication use. The impact of medication reconciliation by healthcare professional on inpatient outcomes has been well demonstrated in some countries.1 In the Netherlands, medication reconciliation by pharmacists at intensive care unit transfers led to a significant decrease medication transfer errors and a cost‐effective reduction in potential harm.9 In England, the addition of pharmacists to healthcare teams would reduce morbidity and health care costs.10 In South Africa, medication reconciliation practiced by multidisciplinary teams, including pharmacists, ensure continuity of patient care throughout patients' hospital stay to decrease adverse drug events.11 However, very few equivalent data are available in Taiwan. Therefore, we designed a before and after intervention study on the effects of implementing medication reconciliation by a pharmacist at geriatric patients' hospital admission.
Cloud medication systems have been developed for medication reconciliation in some countries. However, some systems only provided limited data in local institute and only had patient original prescription with no further computation processing. In the USA, third‐party companies have established a close‐system cloud medical system to allow authorized institutes to upload and share electronic medical records. In Austria, they established e‐Medikation to give access of a patient's nationwide medication list and checked medication safety. We established an intelligent prescription system combined with the national PharmaCloud system to integrate the database with the medical institution computerized physician order entry (CPOE) system and automatically check for health care providers with the medication duplication alert system. It could improve medication integrity and reduce missing data and the occurrence of duplicate prescriptions at elderly hospital admission. The study aimed to measure any improvements resulting from reorganizing the medication reconciliation programme and performed a cost–benefit analysis.
2. METHODS
2.1. Study design
From January 2015 to December 2016, we conducted a pre‐ and postintervention study design. The preintervention phase consisted of 1 year of usual care. In a 9‐month implementation period, the intervention consisted of enhancement of medication reconciliation by pharmacists within 72 hours of patients' admission. We evaluated the intervention impact over 12 weeks of the postintervention phase. A flow‐chart of the study procedure is shown in Figure 1. This study was reviewed and approved by the Kaohsiung Veteran General Hospital Institutional Review Board (IRB; certificate number VGHKS18‐CT7–16). All data were collected from existing electronic medical records, as permitted by the IRB.
Figure 1.
Study procedure pre‐ and postintervention. (A) Usual care prior to the intervention. aMost medication treatment information was collected by patients their providing medication list or the prior medical chart and others from searching on the National Health Insurance PharmaCloud system. (B) Modified process of MR. bAll patients' medication treatment information was downloaded from PharmaCloud system after they sign in informed consents. BPMH, best possible medication history; CPOE, computerized physician order entry; AMO, admission medication order; MR, medication reconciliation
2.2. Setting and study population
One 20‐bed geriatric ward at Kaohsiung Veteran General Hospital (KSVGH) was involved. KSVGH is a medical centre that has about 1500 beds and provides southern Taiwan with quality healthcare, education and research.
Patients who were admitted in the geriatric ward and met the inclusion criteria were enrolled in this study. The inclusion criteria were patients aged 65 years or older with geriatric syndromes or called atypical symptoms (e.g. delirium, falls, incontinence and frailty) for admission, unknown body weight loss, or polypharmacy (≥5 drugs), and who used at least 1 medicine at home. They were excluded if transferred from an intensive care unit or another ward.
2.3. Preintervention phase: usual care
The flow chart of usual care is shown in Figure 1A. First, patients were admitted and provided their medication list. The physician then performed a physical examination of the patients and collected information that included treatment in the emergency department, previous hospitalization, and all currently used medication on the electronic medical chart. Finally, they prescribed admission medication orders (AMO) and recorded treatment information in an admission note of electronic medical chart.
During pharmacists' on‐duty time, every weekday morning from 08:00 to 12:00, they implemented medication reconciliation for geriatric patients within 72 hours after a ward admission.
A clinical pharmacist had to review patients' medication histories on the electronic medical charts, interview the patient and/or caretaker asking for all medication currently in use. After obtaining informed consents from patients, they also checked patients' medication lists by searching the NHI PharmaCloud online system. Medication discrepancies were recorded in the file of pharmacists' visiting documents. Then, clinical pharmacists would discuss medication discrepancies with physicians and supported them to prescribe more appropriate medication for patients in the CPOE. Finally, nurses would check the renewed medication order before administering it to patients.
2.4. The intervention
To improve the implementation rate of medication reconciliation, we performed an intervention to modify the medication reconciliation procedures at admission (Figure 1B). Physicians and pharmacists in the geriatric ward involved in this study. They had professional clinical experience in a medical centre and were certified in long‐term elder care in Taiwan. The intervention consisted of the following 3 items.
To obtain comprehensively patients' medication records from PharmaCloud—to collect the best possible medication history (BPMH)—we introduced patients to the benefit of the PharmaCloud and asked them to provide informed consent to access their medication records on NHI PharmaCloud. Several promotional activities, such as playing videos, and providing posters and seminars, were implemented for patients and healthcare professionals (physicians, nurses etc.) in the hospital. The NHI PharmaCloud announcement videos were played at pharmacies, halls, and bedsides in the geriatric ward.
To reconcile all medications to obtain BPMH, including medications prescribed at ambulatory clinics and other medical institutions, on the medical list during hospitalization, we developed an integrated electronic system, which could integrate all medications in the CPOE system linked with the PharmaCloud database and the electronic medical record. It could download automatically records from PharmaCloud to CPOE system every day and also linked drug identification system of the Taiwan Food and Drug Administration to help identify medications by visual appearance of medication picture database. This was to improve integration of information and reduce missing data. The physician used the electronic integrated system to analyse discrepancies between medications recorded in the PharmaCloud and used at home, and those prescribed on CPOE system at admission, then they could easily reconcile, review and revise all medication orders. If a potential duplicate medication based on pharmacological class (by Anatomical Therapeutic Chemical code), was detected by the integrated system, the physician could adjust it immediately. Clinical pharmacists assisted physicians to assess patients' medication adherence and drug‐related issues such as indication, duplication, dosage, adverse drug reaction and drug interactions, and recorded pharmacist interventions with the SOAP (subjective, objective, assessment, plan) form in the electronic integrated system.
Medication reconciliation not only needs to be documented in patients' medical charts but should also be provided to all health care professionals. We established an electronic platform for coordinated communication with all healthcare professionals (Figure 2). Clinical pharmacists could completely document the results of medication reconciliation and any recommendations on the electronic platform. This platform could record any interventions for patients and allowed bidirectional communication by all healthcare professionals.
Figure 2.
The communication platform for all healthcare professionals. All of this information is brought together on a single platform with the help of page tabs, making it easy for medical professionals to communicate the patient's condition in time and gain quicker access to vital information
2.5. Outcome measures
The primary outcome was the percentage of cases with complete medication reconciliation within 72 hours of admission assessed from the electronic medical records review and pharmacists' visiting documents. We defined medication reconciliation as being completed if both physicians and pharmacists implemented this process within 72 hours of the patient's admission. If information of medications previously used by the patient (from another hospital or prescribed by an outpatient clinic) could not be obtained, healthcare professionals could not get BPHM and would not complete medication reconciliation.
After the physician reviewed all of patients' medication, they integrated BPMH and documented home medications that needed to be taken during hospitalization in the CPOE system. Physicians would receive an alert when a potential duplicate medication was detected by the electronic integrated system. To decrease duplicate medication prescriptions and increase savings on drug expenditure, we encouraged patients to bring and take home medications prescribed from other institutions during hospitalization after physicians and pharmacists verified these home medications.
The secondary outcomes were how many patients continued to take their home medications during hospitalization and how many these home medications were documented instead of being prescribed duplicated medication in CPOE by physicians.
2.6. Cost–benefit analysis
We collected data for total home medications documented in the CPOE system after being integrated by the physician. These data contained the details of each medication prescribed, including its brand or generic name, strength, form, dose, frequency, duration used and unique NHIA identification code.
Some medications could not be mapped with the identified NHIA drug code; therefore, these were replaced with the hospital's drug codes. Using both the NHIA or the hospital's drug code, we matched every item of drug cost covered by the NHIA. All costs were based on Taiwan's NHIA drug pricing system in 2015. We estimated documented home medication expenditures using the cost of every drug multiplied with frequency and duration of use.
2.7. Data collection
Data were collected from the hospital electronic medical records, PharmaCloud databases and medication charts. We recorded patients' characteristics, collected the total number of patients admitted to the geriatric ward, and case numbers of complete medication reconciliation within 72 hours after admission. The number of patients signing informed consent forms to access NHI PharmaCloud pre‐ and postintervention was recorded.
Medication information collected included medicine names, dose form, dose and frequency; at‐home and prescribed medications were integrated in the CPOE system within 72 hours after admission.
The reduced extra medical expenditures, the cost of documented home medications on the CPOE system, were collected and analysed by trained clinical pharmacists.
2.8. Statistical analyses
All data were analysed with IBM SPSS Statistics version 23 (SPSS, Chicago, IL, USA) and Excel 2016 version 3.0. Chi‐square tests were performed for categorical variables analyses, such as the implementation rate of completed medication reconciliation. Normally distributed continuous variables were analysed using the 2‐sample t test, and the Mann–Whitney U test was used for continuous non‐normally distributed variables. We also calculated the relative risk or mean with 95% confidence intervals (CIs) for primary or secondary outcomes. In these tests, a 2‐tailed P‐value of <.05 was considered significant.
3. RESULTS
3.1. Patients' characteristics and intervention outcomes
Three‐hundred patients and 102 patients were admitted to the KSVGH geriatric ward during January to December 2015 and October to December 2016, respectively. Totals of 275 and 91 patients were enrolled in the preintervention and postintervention phases, respectively. The 2 populations were not significantly different from each other concerning basic characteristics (Table 1).
Table 1.
Patients' characteristics
| Characteristic | Preintervention phase (n = 275) | Postintervention phase (n = 91) | P‐value |
|---|---|---|---|
| Age (y), mean (SD) | 84.2 (6.9) | 84.2 (7.9) | .962a |
| Sex, female (%) | 97 (35.3) | 33 (36.3) | .864b |
| Residential situation, n (%) | .572b | ||
| Home | 216 (78.5) | 74 (81.3) | |
| Nursing home | 59 (21.5) | 17 (18.7) | |
| Admitted from, n (%) | .442b | ||
| Emergency room | 202 (73.5) | 62 (68.1) | |
| Outpatient department | 61 (22.2) | 26 (28.6) | |
| Arranged for admission | 12 (4.4) | 3 (3.3) | |
| Period | 1 January–31 December 2015 | 1 October–31 December 2016 |
t test;
χ2 test.
SD, standard deviation.
The rate of providing informed consent to access PharmaCloud significantly differed between the pre‐ and postintervention phases (Table 2). After implementing the promotional activities intervention, more patients signed the PharmaCloud consent form allowing their physicians and pharmacists to access their medication history in the PharmaCloud. The percentages of patients' BPMH obtained within 72 hours of hospital admission were significantly different between the pre‐ and postintervention phases (Table 2).
Table 2.
Intervention outcomes
| At admission items (n, %) | Preintervention phase (n = 275) | Postintervention phase (n = 91) | χ2 | P‐value |
|---|---|---|---|---|
| Primary outcomea | 121 (44.0%) | 79 (86.8%) | 50.568 | .0004 |
| Secondary outcomeb | ||||
| (mean ± SD, per mo) | ||||
| ‐ number of patients | 33.3 ± 9.1 | 40.7 ± 2.5 | .218 | |
| ‐ number of home medications | 121.1 ± 44.6 | 223.6 ± 12.8 | .007 | |
| Informed consent signed for NHI PharmaCloud download | 229 (83.3%) | 87 (95.6%) | 8.815 | .003 |
| BPMH availablec | 197 (71.6%) | 89 (97.8%) | 27.407 | .0004 |
| Major causes of unavailable BPMH | ||||
| Lack of medication lists from | ||||
| ‐ambulatory clinics | 44 (16.0%) | 1 (1.1%) | ||
| ‐other institutions | 34 (12.4%) | 1 (1.1%) |
Primary outcome: the number (percentage) of cases with complete medication reconciliation within 72 hours of admission.
Secondary outcome: the mean ± SD number of patients and home medications documented per month on the computerized physician order entry system.
BPMH, best possible medication history; NHI, National Health Insurance; SD, standard deviation.
3.2. Primary outcome: the percentage of cases with complete medication reconciliation within 72 hours of admission
We included 275 patients in the preintervention and 91 in the postintervention phase at admission. Of these, 121 (44.0%) patients had medication reconciliation implemented under usual care in the preintervention stage. After the intervention to modify the medication reconciliation procedures, 79 (86.8%) patients had complete medication reconciliation in the postintervention stage. There were significant differences between stages (relative risk = 1.97, 95% CI: 1.69–2.31; P < .001).
3.3. Secondary outcome: monthly average of patients and home medications documented on the CPOE system
After we performed intervention, the monthly average of patients who brought and took home medications documented in the CPOE system during hospitalization increased by 7.54 (95% CI 5.58–20.49; P = .22). The monthly average of home medications documented instead of being prescribed by physicians in the CPOE system at admission increased by 102.52 per month (95% CI 38.44–166.60; P < .01) compared with the preintervention phase.
3.4. Cost–benefit analysis
After creating an electronic integrated system, physicians could integrate easily all patients' medications and document home medication instead of prescribing duplicated home medication in the CPOE system. Patients could continue to take home medications prescribed from other institutions during hospitalization, to decrease extra drug expenditure. Savings on the monthly average prescription expenditures of at‐home medications increased by US$ 2795.52 (95% CI US$1310.41–4280.63; P < .01) compared in pre‐ with in postintervention.
4. DISCUSSION
This was the first study to combine NHI PharmaCloud information with a CPOE system to set up an integrated system of medication reconciliation at hospital admission for geriatric patients. Although the study period was different between pre and post stages, it could be considered no significant difference based on the similar patient characteristics (Table 1). Utilizing this integrated system helped decrease prescriptions that duplicated home medication during hospitalization and reduced extra medication expenditures compared pre‐ and postintervention.
Literature reviews have reported the occurrence of medication discrepancies at the time of patients' hospital admission ranges from 30–70%.12, 13 These discrepancies, such as omissions and duplications, could lead to medication errors and adverse drug events that could potentially cause harm. Medication reconciliation is done to avoid medication errors or discrepancies. Obtaining BPMH is an important first step in medication reconciliation. Healthcare professionals need to obtain and record an accurate and complete history of the medicines taken by patients at home. The NHI PharmaCloud database compiles medication records from medical institutions around the country and integrates patients' medication lists among different medical institutions for the previous 3 months. In a preliminary survey of the NHI PharmaCloud system in Taiwan, 895 pharmacist and 105 physician questionnaires were valid for analysis and the questions were scored on a 5‐point scale. A higher score corresponds to a more positive outcome towards satisfaction, more positive attitudes and more positive intentions to use the PharmaCloud system. The results showed that satisfaction score with system quality exhibited 3.42 ± 0.44 for pharmacists and 2.36 ± 0.79 for physicians.6 The PharmaCloud database only could provide patients' medication record from NHI‐contracted medical institutions. We only would obtain a BPMH compared with a gold standard medication list after talking with patients and/or caregivers. Using the PharmaCloud system, we implemented medication reconciliation to find medication discrepancy as an unintended error in prescribing admission medications.14 The PharmaCloud system has been shown to improve the quality of care and prevent 5.83% of duplicated prescriptions.15 Clinical pharmacist‐conducted medication reconciliation could reduce these discrepancies and provide comprehensive and correct medication information for the physician16 and also decreased drug‐related readmissions in paediatric and adult inpatients.17
Admission medication reconciliation processes generally fit into 2 models: the proactive process, the retroactive process or a combination thereof.18 We implemented the retroactive process. Physicians obtained the primary medication history and prescribed admission medication orders. Pharmacists created the BPMH using a systematic process and identified discrepancies to the physicians within 72 hours of admission. The World Health Organization defines that the goal is to reconcile the medications within 24 hours of admission in order to resolve potential problems early in the process.18 Our study goal was modified to 72 hours due to inadequate staffing to perform a BPMH.
Executing medication reconciliation is a very intensive and time‐consuming activity. A BPMH could not be obtained for complex patients with extensive medication histories or for those with incomplete information. The development of a computer‐assisted tool with automated electronic integration of patient‐based medication data was useful to accelerate the procedure of medication reconciliation, improve efficiency, and ensure that patients use medications safely.19 Previous research has reported that the PharmaCloud system facilitates accurate and efficient medication reconciliation by pharmacists for patients with polypharmacy (≥5 medications), to provide a medication therapy management service.20 The intervention in the present study successfully incorporated prescription information from the NHI PharmaCloud system into the hospital's CPOE, and assisted physicians and pharmacists to assess potential duplicate medication and ensure that medications were prescribed safely.
Elderly patients with multiple disease states often require multiple hospital admissions, and consequently have increased opportunities to take duplicate or inappropriate medications. We utilized an electronic integrated system to help physicians integrate patients' medication. This intervention decreased the prescription of duplicated medications and reduced the cost of medications. We expanded this programme to whole hospital and encourage not only patients in geriatrics ward but also all inpatients to bring and take needed home medication during hospitalization. Physicians do not need to prescribe duplicate home medication and only documented patients' home medication on CPOE. This greatly increased economic efficiency, with projected annual savings of US $2.4 million in the whole hospital. Furthermore, reduced medication duplicate prescription means as decreased the production of medication wastage. It could be applicable to other countries to help reduce unused medication.
A previous study found a lack of communication, understanding and collaboration, which healthcare professionals believed influenced the implementation of medication reconciliation.21 We established an electronic platform for coordinated communication with all healthcare professionals. All patient information is brought together on a single platform with the help of page tabs, making it easy for medical professionals to communicate the patients' condition in time and gain quicker access to vital information.
Not only our hospital but also other NHI‐contracted medical institutions have incorporated NHI PharmaCloud information into their internal drug management systems. Since the development of the PharmaCloud system, the number of days on which patient prescriptions overlap has fallen significantly nationwide. Due to more effective use of cloud technology, the NHIA established an NHI MedCloud System at the end of 2015 and it not only involves NHI PharmaCloud System, but also includes other medical records including examination test, surgeries, dental treatment, drug allergies, and usage of certain controlled medications and clotting factor medications. All data could be obtained on a single platform and makes it easier for healthcare professionals to access vital information.22 We will integrate more medical data with NHI‐contracted medical institutions to more quickly understand and manage patients' medical problem.
4.1. Limitations
There were several limitations in our study, including that it was performed in 1 medical centre and focused on a small patient group. Therefore, the discrepancies that we detected might not reflect the overall results of implementing medication reconciliation in the hospital. Further, this study only had 3‐month postintervention periods. The difference in duration of implementation data collection between the pre and post study periods was due to a staged implementation process where various strategies were performed. The various strategies were included promoting signing the informed consent for the PharmaCloud downloaded, developing an integrated electronic system, and establishing an electronic platform. To analyse the full impact of these intervention, data were collected prior to any implementation and after complete intervention with all strategies. The full implementation of the intervention occurred at the end of September 2016, so we evaluated the intervention effect within 3 months before the end of the study. In addition, patient characteristics, the number of healthcare professional participants remained consistent between the 2 periods. The NHI PharmaCloud is a national programme and links a list of patients' prescribed and dispensed medication records for all insured patients. These data could not include all of a patient's medication history, such as self‐funded medication, over‐the‐counter medications, nutritional supplements and herbs. A comprehensive medication review performed by the pharmacist is still necessary and is also a key element in evaluating medication reconciliation.
This integrated system provides easy access to a patients' medication list after this study intervention. No hospital in Taiwan has performed medication reconciliation at patients' discharge, so we will expand this programme to provide a comprehensive customized method for inpatient medication reconciliation from admission to discharge in the future. At the same time, we will establish an automatic detection system to monitor discrepancy between admission medication order and patients' home medication and hope to decrease healthcare professionals' workflow and increase drug safety.
4.2. Conclusions
The present study established a new clinical service model by providing medication reconciliation within 72 hours of admission. Integrating drug data from the NHI PharmaCloud to the hospital's medical chart system assisted the process of medication reconciliation. Improving the implementation rate of medication reconciliation for geriatric patients decreased both duplication of medications and the cost of medications in hospital to greatly increase economic effectiveness.
COMPETING INTERESTS
There are no competing interests to declare.
CONTRIBUTORS
P.‐L.H., J.‐Y.C., and M.‐T.C. designed the study. P.‐L.L., Y.‐T.L. and W.‐C.L. collected data, and Z.‐C.W. was responsible for data analysis. P.‐L.H. drafted the article and P.‐C.L. revised it critically and approved the version to be submitted.
ACKNOWLEDGEMENTS
We thank all the healthcare professionals at the Center for Geriatrics and Gerontology for their contributions and support in patient inclusion and data collection.
Hung P‐L, Chen J‐Y, Chen M‐T, et al. The impact of a medication reconciliation programme at geriatric hospital admission: A pre‐/postintervention study. Br J Clin Pharmacol. 2019;85:2614–2622. 10.1111/bcp.14095
PI statement: The authors confirm that the Principal Investigator for this paper is Pi‐Lien Hung and that she had direct clinical responsibility for patients.
DATA AVAILABILITY STATEMENT
This study was reviewed and approved by the Kaohsiung Veteran General Hospital Institutional Review Board (certificate number VGHKS18‐CT7–16). All data were collected from existing electronic medical records, as permitted by the Institutional Review Board.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
This study was reviewed and approved by the Kaohsiung Veteran General Hospital Institutional Review Board (certificate number VGHKS18‐CT7–16). All data were collected from existing electronic medical records, as permitted by the Institutional Review Board.