Nurse Practitioner–led Medication Reconciliation in Critical Access Hospitals

• This is the first study reporting the effectiveness of the medication reconciliation led by advanced practice nurses (APNs) on medication discrepancies in rural elderly cardiac patients discharged from hospital to home.
• Not only does APN-managed medication reconciliation reduce the number of medication discrepancies, but it also reduces severity of medication discrepancy by identifying and correcting the discrepancies in the classes of medication with high health impact (eg, medications used treat cardiovascular gastrointestinal, neurologic conditions).
• APN-managed medication reconciliation reduces most frequent types of medication discrepancies (eg, incorrect addition and omission).
• APN-managed medication reconciliation increases intentional medication discrepancies by identifying and correcting inappropriate prescriptions for elderly cardiac patient, further reducing and avoiding adverse drug events and rehospitalizations.

Medication discrepancies are common in cardiac patients discharged from hospital to home, leading to increased risk for adverse drug events and hospital readmissions. Medication reconciliation identifies discrepancies and reduces medication error–related adverse drug events. The objective of this study is to examine the effect of advanced practice nurse–managed medication reconciliation on the occurrence of medication discrepancies in elderly cardiac patients discharged from a rural hospital. The study findings showed that advanced practice nurse–managed medication reconciliation reduced the total unintentional medication discrepancies in elderly cardiac patients during the transition from the rural hospital to home.