Pharmacy Times

DEC 2015

Pharmacy Times offers relevant, clinical information for pharmacists that they can use in their daily practice. These include OTC and Rx product news, disease conditions, patient education guides, drug diversion and abuse, and more.

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M edication reconciliation is being discussed frequently in the pharmacy literature because it has become an integral part of the care transition process. I had the opportunity to experience this process myself when I had a total left knee replacement this fall. When I went to the hospital for my pre- operation review, a pharmacist met with me to review the medica- tions I was taking and to prepare a medication list. During that same visit, the pharmacy director reviewed the list and discussed it with me. She shared with me that her team con- siders medication reconciliation a priority and an important contri- bution the pharmacy department makes to the care process. When I returned a few days later for my surgery, I was interviewed by another pharmacist about my medication use. In the course of my care, I had the opportunity to interact with 3 pharmacists about my medication use, demonstrating to me that at least at this hospital, pharmacists are an integral part of the health care team. I was encour- aged about my profession's future as I witnessed the important role pharmacists are playing. In 2007, the American Pharmacists Association and the American Society of Health-System Pharmacists developed the fol- lowing definition for medication reconciliation: "the comprehensive evaluation of a patient's medica- tion regimen anytime there is a change in therapy in an effort to avoid medication errors such as omissions, duplications, dosing errors, or drug interactions, as well as to observe compli- ance and adherence patterns. This process should include a com- parison of the existing and previous medication regimens and should occur at every transi- tion of care in which new medications are ordered, existing orders are rewritten or adjust- ed, or if the patient has added nonprescription medications to [his or her] self-care." I include this definition to show how comprehensive this process should be and how frequently it may need to occur. This definition suggests that most pharmacists providing direct patient care need to engage in medication reconcilia- tion. Perhaps the definition should be expanded to promote the engagement of community phar- macists in medication reconciliation when a patient's medication regi- men changes. Community phar- macists should pursue this with the same enthusiasm my hospital pharmacists had for managing my drug therapy. Our profession has demonstrated that pharmacists can consistently and effectively provide medication reconciliation for patients during care transitions by standardizing the delivery of medication therapy management (MTM). Our profes- sion needs to bring MTM to all patients throughout their care pro- cess, even when a care transition has not occurred. I admit that many ambulatory patients may not perceive the value to this activity, although a few enlightened payers do. As community pharmacists begin interacting directly with patients by engaging them in MTM, espe- cially when a new medication is added, we should be able to improve patients' perception of the value of interacting with a phar- macist. This will require a change in how we practice, but isn't that the reason we are experiencing health care reform? Patients and payers are saying, "We want you to do things differently to achieve improved outcomes." Change is not easy, but unless you are beginning to incorporate medication reconciliation into your practice, you have some quality improvements to make. n Medication Reconciliation: It's Time Fred M. Eckel, RPh, MS, ScD (Hon), Pharmacy Times Editor-in-Chief CARE TO COMMENT ON THIS TOPIC? Message Pharmacy Times on Facebook. MORE @ PHARMACY TIMES.COM Mr. Eckel is professor emeritus at the Eshelman School of Pharmacy, University of North Carolina at Chapel Hill. He is also emeritus executive director of the North Carolina Association of Pharmacists. A lifelong advocate for the profession of pharmacy, Mr. Eckel has lectured on pharmacy issues and trends in all 50 states and has traveled to 6 conti - nents to promote and educate audiences on the role of the pharmacist. Our profes- sion needs to bring MTM to all patients throughout their care process. NEWS PHARMACY VOICES EDITOR'S NOTE Are you involved in med- ication reconciliation? Tweet your experience @Pharmacy_Times 18 PharmacyTimes.com December 2015

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