The ACCURATE Study: Admission Care by Clinical Pharmacy Undergraduate Reconciliation and Transition Experts
Faculty Mentor
Matthew Piccolino
Major/Area of Research
Pharmacy
Description
INTRODUCTION: Medication discrepancies during transitions of care are common and contribute to patient harm. Pharmacy interns represent a scalable workforce to improve medication reconciliation accuracy and have demonstrated effectiveness comparable to pharmacists; however, widespread implementation remains limited. We wish to quantify the frequency and types of medication discrepancies and evaluate the impact of pharmacy intern–led medication reconciliation, performed within 24 hours of admission, on discrepancy burden and patient-level outcomes.
METHODS: This retrospective comparative study evaluated hospitalized patients receiving usual care medication reconciliation (comparator arm, n = 201) versus pharmacy intern–led medication reconciliation (intervention arm, n = 199). Discrepancies were categorized as omissions, commissions, or incorrect dose, frequency, or route.
RESULTS: Primary outcomes included the number and type of discrepancies per patient. Secondary outcomes included the proportion of patients with ≥1 and ≥5 discrepancies, associations with demographic and clinical factors, and 3-, 7-, and 30-day readmission rates.
DISCUSSION/CONCLUSION: Pharmacy intern–led medication reconciliation reduced overall medication discrepancy burden, particularly among patients with complex regimens. These findings support integrating pharmacy interns into medication reconciliation workflows as a scalable strategy to enhance medication safety.
The ACCURATE Study: Admission Care by Clinical Pharmacy Undergraduate Reconciliation and Transition Experts
INTRODUCTION: Medication discrepancies during transitions of care are common and contribute to patient harm. Pharmacy interns represent a scalable workforce to improve medication reconciliation accuracy and have demonstrated effectiveness comparable to pharmacists; however, widespread implementation remains limited. We wish to quantify the frequency and types of medication discrepancies and evaluate the impact of pharmacy intern–led medication reconciliation, performed within 24 hours of admission, on discrepancy burden and patient-level outcomes.
METHODS: This retrospective comparative study evaluated hospitalized patients receiving usual care medication reconciliation (comparator arm, n = 201) versus pharmacy intern–led medication reconciliation (intervention arm, n = 199). Discrepancies were categorized as omissions, commissions, or incorrect dose, frequency, or route.
RESULTS: Primary outcomes included the number and type of discrepancies per patient. Secondary outcomes included the proportion of patients with ≥1 and ≥5 discrepancies, associations with demographic and clinical factors, and 3-, 7-, and 30-day readmission rates.
DISCUSSION/CONCLUSION: Pharmacy intern–led medication reconciliation reduced overall medication discrepancy burden, particularly among patients with complex regimens. These findings support integrating pharmacy interns into medication reconciliation workflows as a scalable strategy to enhance medication safety.