The time burden and implementation of medication reconciliation for inpatients and outpatients in Dutch hospitals

The time burden and implementation of medication reconciliation for inpatients and outpatients in Dutch hospitals Background International guidelines advocate for the implementation of medication reconciliation (MR) in hospitals to improve continuity of care. However, time constraints are a significant barrier to effective implementation.Objective This study aimed to assess the time burden of performing MR in outpatient clinics, at hospital admission and at discharge in Dutch hospitals. Design This observational study was conducted in 35 Dutch hospitals. Methods Master of Pharmacy students from Utrecht University and the University of Groningen performed structured data collection during their internships. A questionnaire was developed by members of the specialist medical care sector in collaboration with the Utrecht Pharmacy Practice Network for Education and Research (UPPER). The primary outcome was the time required to complete MR in Dutch hospitals, or when missing, as measured by the pharmacy students. Secondary outcomes included the risk assessment strategies used by hospital pharmacies to identify patients requiring MR and the implementation of patient portals for MR. Descriptive data analysis was performed using SPSS. Results Data were collected from 65 pharmacy students (30 at outpatient clinics, 35 at hospital admission and discharge). The approximate time required to complete MR was 10-15 minutes in outpatient clinics, 15 minutes at admission, and 20 minutes at discharge. Not all hospital pharmacies used risk assessments to perform MR. Patients had access to a patient portal in 80% of the hospitals, usually without the option to complete MR themselves. Conclusion This is the first study in the Netherlands to quantify the time burden of performing MR in Dutch hospitals. Further research is needed to explore the differences in time burden and implementation strategies between hospitals.