Clinical and economic impact of medication reconciliation in cancer patients: a systematic review
- 1 August 2020
- journal article
- review article
- Published by Springer Science and Business Media LLC in Supportive Care in Cancer
- Vol. 28 (8), 3557-3569
- https://doi.org/10.1007/s00520-020-05400-5
Abstract
Purpose Medication reconciliation can reduce drug-related iatrogenesis by facilitating exhaustive information transmission at care transition points. Given the vulnerability of cancer patients to adverse drug events, medication reconciliation could provide a significant clinical benefit in cancer care. This review aims to synthesize existing evidence on medication reconciliation in cancer patients. Methods A comprehensive search was performed in the PubMed/Medline, Scopus, and Web of Science databases, associating the keywords "medication reconciliation" and "cancer" or "oncology." Results Fourteen studies met the selection criteria. Various medication reconciliation practices were reported: performed at admission or discharge, for hospitalized or ambulatory patients treated with oral or parenteral anticancer drugs. In one randomized controlled trial, medication reconciliation decreased clinically significant medication errors by 26%. Although most studies were non-comparative, they highlighted that medication reconciliation led to identification of discrepancies and other drug-related problems in up to 88% and 94.7% of patients, respectively. The impact on post-discharge healthcare utilization remains under-evaluated and mostly inconclusive, despite a trend toward reduction. No comparative economic evaluations were available but one study estimated the benefit:cost ratio of medication reconciliation to be 2.31:1, suggesting its benefits largely outweigh its costs. Several studies also underlined the extended pharmacist time required for the intervention, highlighting the need for further cost analysis. Conclusion Medication reconciliation can reduce adverse drug events in cancer patients. More robust and economic evaluations are still required to support its development in everyday practice.This publication has 42 references indexed in Scilit:
- Medication reconciliation at admission and discharge: a time and motion studyBMC Health Services Research, 2013
- Implementing a Standardized Pharmacist Assessment and Evaluating the Role of a Pharmacist in a Multidisciplinary Supportive Oncology ClinicThe Journal of Supportive Oncology, 2012
- Characteristics of medication errors with parenteral cytotoxic drugsEuropean Journal of Cancer Care, 2012
- Inpatient medication reconciliation at admission and discharge: A retrospective cohort study of age and other risk factors for medication discrepanciesThe American Journal of Geriatric Pharmacotherapy, 2010
- Polypharmacy in Older Adults with CancerThe Oncologist, 2010
- Reduction of 30‐day postdischarge hospital readmission or emergency department (ED) visit rates in high‐risk elderly medical patients through delivery of a targeted care bundleJournal of Hospital Medicine, 2009
- Medication Errors Among Adults and Children With Cancer in the Outpatient SettingJournal of Clinical Oncology, 2009
- An innovative approach to integrated medicines managementJournal of Evaluation in Clinical Practice, 2007
- Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patientsBMJ, 2004