Development of a Medication Reconciliation Model to Enhance Patient Safety Among Chronic Disease Patients at Ao Luk Hospital, Krabi Province

Abstract

Medication reconciliation is a process that prevents medication errors and enhances safety for patients with chronic diseases. This research and development aimed to develop a medication reconciliation model and evaluate its effectiveness in improving medication safety in patients with chronic diseases at Ao Luk Hospital, Krabi Province. The study was conducted in three phases: 1. Situation analysis, studying 30 personnel and 2,665 chronic disease patient records. 2. Development of a medication coordination model in collaboration with a multidisciplinary team, including training, designing forms linked to the medical record system, and establishing standard operating procedures. 3. Pilot testing and continuous follow-up for 5 months, studying 30 personnel and 2,714 chronic disease patients. Data were analyzed using descriptive statistics, content analysis, and paired t-test.

Results: In phase 1, personnel had low to moderate knowledge and attitudes towards medication reconciliation, and the medication error rate was 2.74%. In phase 2, a medication reconciliation model was developed that covers three stages of care: initial patient admission, during care, and before discharge. This model was developed through practical training and on-the-job instruction. Learning from case studies in Phase 3, following the implementation of the model, showed a statistically significant increase (p < 0.001) in the knowledge and attitudes of personnel. Satisfaction was at a high level, the medication error rate decreased from 2.74% to 0.18%, and the completeness of the forms increased to 96.7%. In conclusion, the developed medication reconciliation model is clearly effective in reducing medication errors and increasing the safety of patients with chronic diseases, and can be applied in community hospitals.