The impact of medication reconciliation on discrepancies and all-cause readmission among hospitalised patients with chronic kidney disease: a quasi-experimental study.

Background: Chronic kidney disease (CKD) with its associated comorbidities and pill burden can expose patients to a heightened risk of drug-related problems, including medication discrepancies. This study aimed to evaluate the impact of medication reconciliation supplemented with medication review on the number of medication discrepancies at discharge and all-cause readmission among CKD patients.

Methods: This was a quasi-experimental trial among adult CKD patients admitted into two major referral hospitals in northern Jordan. Patients in the intervention group received medication reconciliation supplemented with medication review by a clinical pharmacist, while those in the control group received the usual care. The recognised discrepancies were evaluated at admission and at discharge in both groups. Participants were followed for 90-day readmission.

Results: Among patients in the intervention group, the average number of discrepancies was 2.5 ± 2.2 per CKD patient. Compared to the control group, the reduction in discrepancy numbers between admission and discharge was higher in the intervention group by 1.66 discrepancies. The likelihood of 90-day readmission was significantly lower in the intervention group (OR = 0.41; P = 0.002).

Conclusion: Supplemented medication reconciliation among CKD patients reveals a favourable impact on medication discrepancies and readmission rates. Optimising medication management during transitions of care can improve overall health outcomes.