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Comparison between proactive and retroactive models of medication reconciliation in patients hospitalized for acute decompensated heart failure.

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Title: Comparison between proactive and retroactive models of medication reconciliation in patients hospitalized for acute decompensated heart failure.
Authors: Ahmadimoghaddam, Davoud1, Akbari, Paniz2, Mehrpooya, Maryam2 m_mehrpooya2003@yahoo.com, Entezari-Maleki, Taher3 m_mehrpooya2003@yahoo.com, Rangchian, Maryam2, Zamanirafe, Maryam4, Parvaneh, Erfan5, Mohammadi, Younes6
Source: International Journal of Risk & Safety in Medicine. 2024, Vol. 35 Issue 2, p143-158. 16p.
Subject Terms: *MEDICATION errors, *ACADEMIC medical centers, *RESEARCH funding, *MEDICATION reconciliation, *HEART failure, *DESCRIPTIVE statistics, *LONGITUDINAL method, *MATHEMATICAL models, *RESEARCH methodology, *THEORY, *HOSPITAL pharmacies, *NONPRESCRIPTION drugs
Geographic Terms: IRAN
Abstract: BACKGROUND: Most research on the impact of medication reconciliation on patient safety focused on the retroactive model, with limited attention given to the proactive model. OBJECTIVE: This study was conducted to compare the proactive and retroactive models in patients hospitalized for acute decompensated heart failure. METHODS: This prospective, quasi-experimental study was conducted over six months, from June to November 2022, at the cardiology unit of an academic hospital in Iran. Eligible patients were those hospitalized for acute decompensated heart failure using a minimum of five regular medications before admission. Medication reconciliation was performed in 81 cases using the proactive model and in 81 using the retroactive model. RESULTS: 556 medications were reconciled using the retroactive model, and 581 were reconciled using the proactive model. In the retroactive cases, 341 discrepancies (both intentional and unintentional) were identified, compared to 231 in the proactive cases. The proportion of patients with at least one unintentional discrepancy was significantly lower in the proactive cases than in the retroactive cases (23.80% versus 74.03%). Moreover, the number of unintentional discrepancies was significantly lower in the proactive cases compared to the retroactive cases (22 out of 231 discrepancies versus 150 out of 341 discrepancies). In the retroactive cases, medication omission was the most frequent type of unintentional discrepancy (44.00). About, 42.70% of reconciliation errors detected in the retroactive cases were judged to have the potential to cause moderate to severe harm. While the average time spent obtaining medication history was similar in both models (00:27 [h: min] versus 00:30), the average time needed to complete the entire process was significantly shorter in the proactive model compared to the retroactive model (00:41 min versus 00:51). CONCLUSION: This study highlighted that the proactive model is a timely and effective method of medication reconciliation, particularly in improving medication safety for high-risk patients. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Risk & Safety in Medicine is the property of IOS Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Comparison between proactive and retroactive models of medication reconciliation in patients hospitalized for acute decompensated heart failure.
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  Data: <searchLink fieldCode="AR" term="%22Ahmadimoghaddam%2C+Davoud%22">Ahmadimoghaddam, Davoud</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Akbari%2C+Paniz%22">Akbari, Paniz</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Mehrpooya%2C+Maryam%22">Mehrpooya, Maryam</searchLink><relatesTo>2</relatesTo><i> m_mehrpooya2003@yahoo.com</i><br /><searchLink fieldCode="AR" term="%22Entezari-Maleki%2C+Taher%22">Entezari-Maleki, Taher</searchLink><relatesTo>3</relatesTo><i> m_mehrpooya2003@yahoo.com</i><br /><searchLink fieldCode="AR" term="%22Rangchian%2C+Maryam%22">Rangchian, Maryam</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Zamanirafe%2C+Maryam%22">Zamanirafe, Maryam</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Parvaneh%2C+Erfan%22">Parvaneh, Erfan</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Mohammadi%2C+Younes%22">Mohammadi, Younes</searchLink><relatesTo>6</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22International+Journal+of+Risk+%26+Safety+in+Medicine%22">International Journal of Risk & Safety in Medicine</searchLink>. 2024, Vol. 35 Issue 2, p143-158. 16p.
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  Data: *<searchLink fieldCode="DE" term="%22MEDICATION+errors%22">MEDICATION errors</searchLink><br />*<searchLink fieldCode="DE" term="%22ACADEMIC+medical+centers%22">ACADEMIC medical centers</searchLink><br />*<searchLink fieldCode="DE" term="%22RESEARCH+funding%22">RESEARCH funding</searchLink><br />*<searchLink fieldCode="DE" term="%22MEDICATION+reconciliation%22">MEDICATION reconciliation</searchLink><br />*<searchLink fieldCode="DE" term="%22HEART+failure%22">HEART failure</searchLink><br />*<searchLink fieldCode="DE" term="%22DESCRIPTIVE+statistics%22">DESCRIPTIVE statistics</searchLink><br />*<searchLink fieldCode="DE" term="%22LONGITUDINAL+method%22">LONGITUDINAL method</searchLink><br />*<searchLink fieldCode="DE" term="%22MATHEMATICAL+models%22">MATHEMATICAL models</searchLink><br />*<searchLink fieldCode="DE" term="%22RESEARCH+methodology%22">RESEARCH methodology</searchLink><br />*<searchLink fieldCode="DE" term="%22THEORY%22">THEORY</searchLink><br />*<searchLink fieldCode="DE" term="%22HOSPITAL+pharmacies%22">HOSPITAL pharmacies</searchLink><br />*<searchLink fieldCode="DE" term="%22NONPRESCRIPTION+drugs%22">NONPRESCRIPTION drugs</searchLink>
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– Name: Abstract
  Label: Abstract
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  Data: BACKGROUND: Most research on the impact of medication reconciliation on patient safety focused on the retroactive model, with limited attention given to the proactive model. OBJECTIVE: This study was conducted to compare the proactive and retroactive models in patients hospitalized for acute decompensated heart failure. METHODS: This prospective, quasi-experimental study was conducted over six months, from June to November 2022, at the cardiology unit of an academic hospital in Iran. Eligible patients were those hospitalized for acute decompensated heart failure using a minimum of five regular medications before admission. Medication reconciliation was performed in 81 cases using the proactive model and in 81 using the retroactive model. RESULTS: 556 medications were reconciled using the retroactive model, and 581 were reconciled using the proactive model. In the retroactive cases, 341 discrepancies (both intentional and unintentional) were identified, compared to 231 in the proactive cases. The proportion of patients with at least one unintentional discrepancy was significantly lower in the proactive cases than in the retroactive cases (23.80% versus 74.03%). Moreover, the number of unintentional discrepancies was significantly lower in the proactive cases compared to the retroactive cases (22 out of 231 discrepancies versus 150 out of 341 discrepancies). In the retroactive cases, medication omission was the most frequent type of unintentional discrepancy (44.00). About, 42.70% of reconciliation errors detected in the retroactive cases were judged to have the potential to cause moderate to severe harm. While the average time spent obtaining medication history was similar in both models (00:27 [h: min] versus 00:30), the average time needed to complete the entire process was significantly shorter in the proactive model compared to the retroactive model (00:41 min versus 00:51). CONCLUSION: This study highlighted that the proactive model is a timely and effective method of medication reconciliation, particularly in improving medication safety for high-risk patients. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of International Journal of Risk & Safety in Medicine is the property of IOS Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.3233/JRS-230034
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 16
        StartPage: 143
    Subjects:
      – SubjectFull: IRAN
        Type: general
      – SubjectFull: MEDICATION errors
        Type: general
      – SubjectFull: ACADEMIC medical centers
        Type: general
      – SubjectFull: RESEARCH funding
        Type: general
      – SubjectFull: MEDICATION reconciliation
        Type: general
      – SubjectFull: HEART failure
        Type: general
      – SubjectFull: DESCRIPTIVE statistics
        Type: general
      – SubjectFull: LONGITUDINAL method
        Type: general
      – SubjectFull: MATHEMATICAL models
        Type: general
      – SubjectFull: RESEARCH methodology
        Type: general
      – SubjectFull: THEORY
        Type: general
      – SubjectFull: HOSPITAL pharmacies
        Type: general
      – SubjectFull: NONPRESCRIPTION drugs
        Type: general
    Titles:
      – TitleFull: Comparison between proactive and retroactive models of medication reconciliation in patients hospitalized for acute decompensated heart failure.
        Type: main
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            NameFull: Ahmadimoghaddam, Davoud
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            NameFull: Akbari, Paniz
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            NameFull: Mehrpooya, Maryam
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            NameFull: Entezari-Maleki, Taher
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            NameFull: Rangchian, Maryam
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            NameFull: Zamanirafe, Maryam
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            NameFull: Parvaneh, Erfan
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            NameFull: Mohammadi, Younes
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            – D: 01
              M: 04
              Text: 2024
              Type: published
              Y: 2024
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              Value: 35
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            – TitleFull: International Journal of Risk & Safety in Medicine
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