Pharmacist-led medication reconciliation improves drug safety in patients initiating chemotherapy

Medication change is common among cancer patients, according to a study, noting that a brief oncology pharmacist-led medication reconciliation (PMR) can help prevent prescribing and administration errors, hence improving drug safety.

“PMR may be important for cancer patients initiating new therapies, as they have a high burden of medication use and are more susceptible to inadvertent medication discrepancies,” the authors said.

Some 397 cancer patients initiating chemotherapy underwent a PMR at the University of North Carolina Cancer Hospital from October 2011 to March 2012. Self-reported medications and those in the patients’ electronic health record were reviewed.

The authors estimated adjusted prevalence ratios and 95 percent confidence intervals (CIs) for the associations between patient characteristics and medication changes made to the electronic health record using log-binomial regression models.

Mean age at time of the PMR was 58 years, and the median time to PMR completion was 11 min. The median number of medications taken prior to the intervention was 10.

Vitamins and herbal supplements were the most frequently added (38 percent) and modified (20 percent) medications, while antimicrobials contributed the largest proportion of discontinuations (15 percent).

Patients aged 60–69 years were more likely to have medication additions compared to those aged ≤50 years (adjusted prevalence ratio [PR], 1.47, 95 percent confidence interval [CI], 1.10–1.97) after adjustment for all other covariates. Modifications were more prevalent among patients aged ≥70 years (adjusted PR, 1.74, 95 percent CI, 1.07–2.82).

“PMR ensures adequate recording and use of medications by patients,” the authors said.