medication reconciliation
Systematic process of obtaining accurate medication histories and resolving discrepancies to prevent adverse drug events in older adults.
Full Definition
Medication reconciliation is a formal process designed to create comprehensive and accurate medication lists at every transition of care, including admission, transfer, and discharge from healthcare facilities. In geriatric psychiatry, this process is particularly critical given the high prevalence of polypharmacy, cognitive impairment affecting medication recall, and complex medication regimens involving multiple prescribers. The process involves obtaining complete medication histories from multiple sources (patient, family, pharmacy, previous providers), identifying discrepancies between documented and actual medications, and resolving conflicts through clinical review. Special attention is given to high-risk medications, over-the-counter drugs, supplements, and psychotropic medications. Effective medication reconciliation reduces medication errors, prevents drug interactions, and ensures continuity of appropriate therapy while identifying opportunities for deprescribing inappropriate medications.
Usage
Usage note: Two words; emphasize systematic nature of process.
In Context
- "Medication reconciliation revealed the patient was taking duplicate antidepressants prescribed by different providers." — pharmacy consultation note
- "The admission medication reconciliation identified five potentially inappropriate medications per Beers Criteria." — geriatric psychiatry evaluation