Effects of Medication Reconciliation Process after Computer Program Development in Outpatient Dispensing Service System at Songklanagarind Hospital

Abstract

Objective: To study the effects of medication reconciliation process after the implementation of the computer program in outpatient dispensing service system at Songklanagarind Hospital on medication error prevention, patients’ waiting time at pharmacy and satisfaction of the program among pharmacists. Methods: The medication reconciliation process after developed computer program of outpatient dispensing service was implemented in 2011. The researchers analyzed prescribing error reports in 2011 and compared patients’ waiting time at busy hours of the pharmacy before and after program implementation (at 2011 and 2012). In addition, the satisfaction of 40 pharmacists toward this program was surveyed. Results: Medication reconciliation process with the computer program identified 306 medication errors, accounted for 11% of the total report of medication error in 2011 (2,712 reports). Of these 58% were prescribing errors with an inappropriate amount of prescribed medications relative to date of next appointment. Eighteen were the omission of the necessary drugs being used by the patients. Thirteen percent were inappropriate and unintentional modification of drug dosage forms, strengths and instructions by physicians. Seven percent were the prescribing of medication with therapeutic duplication. Four percent were drug-drug interactions. If the program was not developed and implemented, these errors would have been undetected or taken a longer time to be detected. Waiting time at the busy hours of pharmacy before and after program implementation was 12.17 and 10.09 minutes, respectively. Program implementation was considered to have no effects on outpatient dispensing service system and waiting time was within the target of the hospital (≤15 minutes).The pharmacists showed a high level of satisfaction to the developed program due to its user friendliness, and its usefulness in the prevention of medication error. Conclusion: The effects of medication reconciliation process after program developed in outpatient dispensing service system at Songklanagarind Hospital improved patient safety without prolonging the waiting time. The pharmacists were satisfied with this program. The pharmacy department should continuously improve the medication reconciliation process and the program concurrently that it could be used at every service provision point where medication reconciliation is needed.