Category: Professional Posters
Purpose: Beginning January 2019, California Senate Bill 1254 (SB 1254) mandates that hospital pharmacies in California obtain an accurate home medication list for each high risk patient. Pharmacy technicians and other pharmacy extenders serve as a solution to SB 1254. The purpose of the study is to evaluate the impact of pharmacy technician driven medication reconciliation program in obtaining an accurate patient medication profile.
Methods: : Retrospective chart review from January 2018 to June 2018. Mercy San Juan Medical Center is a 370-bed, level II trauma center located in Carmichael, CA. The charts for 171 patients who were interviewed by the Transitions of Care (TOC) pharmacy technician were reviewed for data analysis. It is the standard of practice that all the patients have medication histories obtained upon admission by a nurse prior to reconciliation by the admitting physician. The pharmacy technicians performed the Best Practice Medication History (BPMH) process after admitting medication reconciliation was completed. The technician obtained a medication list from the retail pharmacy and/or third party payer claims data and compared the list to the documented home medication list in the profile (created by the RN). The technician then interviewed either the patient or caregiver to clarify the discrepancies between the documented home medication profile and the BMPH. The home medication profile was then updated by the technician with the corrections. All of the changes post– BPMH were reviewed by a pharmacist. Patients included in the study were non-intensive care unit patients, age greater than 18 years, and admitted within the study period. The primary outcome is to determine the types of interventions the pharmacy technician can perform during medication reconciliation. The secondary outcome is to review the number of interventions.
Results: The collected data was analyzed using percentage and numerical distribution. 95% of BPMH (n=171) performed by technicians did not require further pharmacist intervention to obtain an accurate home medication profile. Technicians were able to accurately create a medication history list for patients with minimum to no assistance. The interventions performed by the pharmacy technician include adding omitted medications, removing discontinued medications from the medication list, and modifying existing entries. 81% of the patients had 1 or more medications added to the profile. 87% of the patients had medications removed from their profile, 66% of the patients had incomplete or inaccurate medication entries that were corrected (wrong dose, frequency, or directions). Most of the patients had a combination of various interventions. Of note, 64% of the patients had high risk medications as part of their medication history. High risk medications in this study refer to anticoagulants, diabetic agents and opioids.
Conclusion: Implementing SB 1254 will allow hospitals to obtain accurate medication histories and improve patient care for high- risk patients. 95 % of the Best Practice Medication Histories obtained by pharmacy technicians did not require further pharmacist intervention to complete an accurate home medication record. Hospitals can utilize pharmacy technicians to construct a more accurate home medication history record for high risk patients.