Matching medication lists for hospital patients

An experiment to make medication lists for hospital patients more accurate worked better than usual methods, potentially avoiding drug-related problems, a small study at two Boston hospitals shows.

Researchers led by Dr. Jeffrey L. Schnipper of Brigham and Women's Hospital tested a new process for reconciling the lists of drugs patients are taking when they arrive at the hospital with the medications they receive in the hospital or are sent home to take. About two out of three patients nationwide have at least one unexplained discrepancy in their medication lists when they are admitted, Schnipper and his co-authors note in tomorrow's Archives of Internal Medicine.

The researchers created a new process for checking drug lists, including a Web-based component that could draw electronic information from a variety of sources into a medication list. Physicians, nurses, and pharmacists changed the way they worked in order to generate the list.

The new process was compared to the usual method for 322 patients admitted and discharged over two months at the Brigham and at Massachusetts General Hospital. There were 170 medication discrepancies that could have caused harm among 162 patients assigned to the new process. That compares to 230 medication discrepancies among 160 receiving the usual care.

The authors call their intervention "far from perfect," but still successful because it combined information technology with a new process of cross-checking and communicating among doctors, nurses, and pharmacists to improve safety.