Impact of pharmacological services in delivering quality health care - An Orthopaedic Unit experience from a tertiary care Medical College

In India, it is not a routine practice to involve pharmacological services in daily clinical work. The importance of pharmacist along with the clinicians has been demonstrated by various studies in Western population. This study aims to assess the impact of pharmacist - conducted medication reconciliation performed in an Orthopaedic Unit in a tertiary care medical college in India. Department. This was a prospective study conducted in a tertiary-care teaching hospital in India between June 2023 and May 2024. Participants were inpatients hospitalized in a single Orthopaedic Unit during the study period. The Pharm D intern posted in the unit obtained the Best Possible Medication History (BPMH) and led the reconciliation process. The primary objective was to find out the number of reconciliation errors (REs). Descriptive statistics were used to report participants’ responses and relevant findings. Linear regression was performed with the number of REs as a continuous dependent variable using backward method. Results were assumed to be significant when p was <0.05. Among 400 patients, majority were males (64 %). Mean age was 68.1 years. [Range – 5 yrs to 93 years]. 15 % of patients had more than ≥5 home medications. 7 % of patients reported pre-existing drug allergy atleast to a medication. A total of 48 prescription errors were identified in 40 patients. The most common discrepancies consisted of medication omission (79.1 %), followed by incorrect dosing. Six REs were judged as clinically significant, and one as serious. The most common error noted was omission of a drug (74 %) followed by wrong dosing. The number of own medications showed significant association with the number of REs ( p < 0.001). Pharm D intern-led medication reconciliation can reduce reconciliation errors and improve medication safety and quality health care.