Medication reconciliation and its essentiality in the geriatric population: A comprehensive review

Medication reconciliation (MedRec) is a dedicated, patient-centered process with inter-professional collaboration that contributes to optimal medication management. However, evidence on the impact of MedRec in geriatric population is inadequate. This narrative review aims to comprehensively explain the MedRec process, its effectiveness in the geriatric population, and the barriers associated with its implementation, also focusing on practical questions associated with effective MedRec: when and where it should occur, contribution of healthcare providers in conducting it, and its implementation in hospitals. A comprehensive literature search was performed using appropriate keywords in MEDLINE, EMBASE, Scopus, Google Scholar, and Web of Science databases to identify relevant clinical studies, systematic reviews, and narrative reviews from 1993 to 2024. The studies were screened based on their title or abstract, and the most relevant papers were included. Polypharmacy was found to be very common among elderly patients with multiple comorbidities which lead to inappropriate prescriptions, adverse drug effects (ADEs), increased duration of hospitalization, decreased quality of life, and increased healthcare costs. MedRec prevents these errors and in turn enhances the quality of care. MedRec was found to reduce ADEs, duration of stay, hospital admissions and readmissions, or fatality. Significant clinical outcomes were also observed in terms of increased overall survival, lower death rate, fewer falls, and enhanced social interaction, mood, and attentiveness. MedRec is required at interfaces of care and transitions between facilities such as acute hospital care, community, or long-term care where patients are prone to higher risk for medication discrepancies. MedRec has shown significant results but its large-scale implementation is still challenging due to barriers such as obtaining an insufficient best possible medication history, lack of inter-professional collaboration, inadequate staffing, lack of resources, or complications in workflow. The collaboration of healthcare providers (especially pharmacists and geriatricians) is crucial for its effective implementation among geriatric population for improved management of medication risks.