Implementation and evaluation of pharmacist-led medication reconciliation in pediatric patients

Medication errors and adverse drug events are more frequently observed in the pediatric population compared to the adult population, and they carry greater significance depending on various factors. Errors related to medication discrepancies often occur during transitions between care facilities, especially when patients are receiving new medications or changes are made to their existing ones; 60% of these errors occur during hospital admission, transfer, or discharge. Medication reconciliation has been proven to be an effective method in reducing medication errors (70-80%) and adverse drug events (over 15%). The aim of this study is to identify and classify unintentional medication discrepancies during hospitalization and transitions of care in the pediatric health and diseases service through medication reconciliation services. Additionally, the study aims to evaluate the appropriateness of the medications used by patients and to identify and classify drug-related problems during inpatient care. The study, conducted as a prospective cross-sectional study between August 2022 and February 2023, utilized medication reconciliation to identify unintentional medication discrepancies using MedTax (The Medication Discrepancy Taxonomy), and drug-related problems (DRPs) were classified using PCNE v9.1. Among the 105 included patients in our study, DRPs were detected in 68 (64.76%) patients. A total of 204 DRPs were identified, ranging from 1 to 8 per patient. In 23.8% of the included patients (n=25), at least one unintentional medication discrepancy was identified during admission or transitions between services. A total of 47 (9.07%) unintentional discrepancies were identified. Among the identified 47 unintentional medication discrepancies, 80.15% were complete medication discrepancies, while 19.15% were partial medication discrepancies. The most common type of medication discrepancy was the omission of medication (n=37). Among the identified DRPs, 62.74% (n=128) were related to the effectiveness of the medication, 24% (n=49) to the safety of the medication, and 13.26% (n=27) to other reasons. The most common reason for DRPs identified was drug selection, accounting for 41.17% of the participants, followed by dose selection and patient transfer at rates of 29.41% and 23.03%, respectively. The results of our study indicate that DRPs can be effectively identified by clinical pharmacists. The detection of DRPs by clinical pharmacists will contribute to the promotion of rational drug use.