Abstract Details

Title Defining and Understanding Barriers to Medication Reconciliation in the Outpatient Neurology Clinic

Topic Practice, Policy, and Ethics

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 1-003

Background Medications, dosages, and frequencies are often changed during transitions in care which can potentially lead to medication errors. Medication reconciliation, when done effectively, can reduce the likelihood of such errors. Barriers to effectively completing this process in the ambulatory setting can exist in several forms. Understanding resident views on the process may elucidate specific barriers to address in the neurology clinic and improve quality of care.

Objective To identify, understand, and attempt to address barriers to efficient, accurate medication reconciliation performed during patient encounters in the outpatient neurology clinic at a Midwestern safety net hospital.

Design/Methods An anonymous online survey was conducted using RedCAP and distributed to all neurology residents (9) at the University of Missouri-Kansas City School of Medicine and summative evaluation results were assessed. An informative seminar was presented regarding medication reconciliation and a similar survey was administered following the seminar.

Results We received 9 out of 9 survey responses for each survey (100% response rate). In the initial survey, 67% of residents indicated spending fewer than 5 minutes on medication reconciliation and were skeptical patients would recall their medication list. Most frequently chosen barriers among residents included patient unfamiliarity (89%), lengthy medication list (67%), and the electronic health record not being up-to-date (67%). The best method residents thought would help the reconciliation process was through information collected by other clinic staff during the encounter (44%). Following a brief seminar, 55.6% of residents indicated they would spend more time on medication reconciliation, specifically conducting reconciliation themselves instead of solely clinic staff. The majority of residents believed improving patient health literacy was key to effective medication reconciliation.

Conclusions Health literacy, time per encounter, and inconsistency in updating electronic health records were commonly identified barriers to medication reconciliation. A multifaceted approach involving both the physician and patient is necessary to effectively improve medication reconciliation.

Authors/Disclosures
Alex J. Luke, MD PRESENTER	Dr. Luke has nothing to disclose.
Debolina Kanjilal, MD (OSU)	Ms. Kanjilal has nothing to disclose.
Binod Wagle, MD, FAAN (Providence Medical Group)	Dr. Wagle has nothing to disclose.