MedManage: The development of a tool to assist medication reconciliation in a rural primary care clinic.
Traci Jarrett, Jill Cochran, Adam Baus and 1 others
PMID 30829980WHAT IT FOUND
Staff-assisted body-map medication lists captured previously unreported medicines in a rural clinic pilot: 82% of patients had an over-the-counter as-needed medication and 28% listed a vitamin not previously recorded.
Missed medicines were common, but the pilot did not test if errors fell.
Key findings
01Forty percent of audited patient charts had incomplete or inaccurate medication lists.
02With staff assistance in the waiting room, 82% of patients had an over-the-counter medication taken as needed that had not previously been recorded, 28% listed a vitamin not previously recorded, and 14% listed a new lotion not previously recorded.
03Implementation barriers included needing staff help for patients and electronic health records not capturing over-the-counter, herbal, or PRN medications.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 38 patients were audited, and the pilot was run with a single adult care provider over a 3-week period, so it is small and may not reflect other clinics. It did not report a comparison group or test whether medication errors, adverse events, or readmissions were reduced. The partner hospital dropped out early because of staff turnover, so the study did not test the full transition from hospital to primary care. Electronic health records did not reliably show over-the-counter, herbal, or PRN medications, and those entries could push prescription medications down the chart. Some patients found the tool hard to follow, were reluctant to disclose all medications, or needed staff help in the waiting room. A results sentence says 'eighty-five of the patients' had a change in active medications. Only 38 patients were evaluated, so that figure is unclear.
Declared interests
The authors report no conflict of interest. The supplied text does not give a separate funding statement.
The easy way to misread this
Do not conclude that MedManage reduces medication errors or readmissions. The pilot audited 38 patient charts and found previously unreported over-the-counter and vitamin medications, but it did not report a comparison group or measure medication errors.