Medication Reconciliation Processes in In-patient Department of Public Hospitals in Region 7 of National health Security Office, Ministry of Public Health

Abstract

This descriptive research was aimed to study the medication reconciliation processes in cases of in-patients of public hospitals. The study hospitals are 63 public hospitals in Region 7 of National Health Security Office, Ministry of Public Health. Using the semi-structured interview questionnaire, the researcher interviewed 71 pharmacists, who were mainly responsible for medication reconciliation processes of each hospital. The interviews were conducted during October 1, 2015 to January 31, 2016.   

Only six hospitals had the processes that was completed to the concepts of medication reconciliation with four components; verification, clarification, reconciliation, and transmission. Fifty four  hospitals had the processes which were partly covered the concepts. The medication reconciliation processes of some hospitals were executed in the patient admission process, while others were executed in the in-patient discharge process. In three hospitals, the medication reconciliation processes were not complete as the suggestion according to the lack in two major components; the reconciliation and the transmission.

There were a wide variety of the medication reconciliation processes among study hospitals. The processes varied in terms of selected patients groups, time of ending in admission process, selected sources of information for patient medical history, algorithms of medication reconciliation processes, and health professional personals who involved in the processes. Additionally, the readiness of each hospital for the medication reconciliation procedure was varied. The factors influencing medication reconciliation procedure could be classified into four groups, 1) the context of hospitals 2) the hospital policies 3) the clear processes 4) health professional personals

The medication reconciliation process was important to all study hospitals, though the operation guidelines of medication reconciliation of each hospital were varied according to hospitals’ contexts. The influencing factors to readiness of each hospital support the completeness of medication reconciliation process and the coverage of patients, and these would lead to patient safety goals.