ABSTRACT
Description Over a year has passed since the discovery of SARS-CoV-2 and the subsequent COVID-19 pandemic. As mitigation efforts continue, COVID-19 has claimed over half a million lives in the United States and 3.1 million lives globally. The development and availability of vaccines delivering immunity to prevent COVID-19 offers hope to end the pandemic. Emergency use authorizations from the Food and Drug Administration have been issued in the United States for three vaccines, one each from Pfizer-BioNTech, Moderna and Janssen/J&J. Pfizer-BioNTech and Moderna are both mRNA vaccines with efficacy of 95% and 94.1% respectively, while the vector-based vaccine from Janssen/J&J has an overall efficacy of 66.1%. The Janssen/J&J vaccine, having received the most recent authorization, is an attractive option due to high efficacy with a single dose. With a high immunity rate of 70-80% needed to prevent the continued spread of the virus and mutations, the majority of the population will require vaccination. The rise of mutations from selective pressure has further increased the urgency. Recent discoveries of variants have led to uncertainties regarding the impact of immunity and effectiveness of vaccines. In order to end the global pandemic, it is essential that the Centers for Disease Control and World Health Organization monitor the variant potential and educate the public appropriately to encourage appropriate vaccination and allocation of product. Achieving high vaccination rates in the U.S. has been challenged by supply, storage requirements and public hesitancy. In a recent Gallup poll, a random sample of 4,098 adults demonstrated that 71% of survey respondents were willing to receive a vaccine, which remains on the lower end of the 70-80% vaccination range required to end this pandemic. Despite these challenges, the United States has managed to surpass 225 million vaccinations.
ABSTRACT
Background: Pharmacy-led medication reconciliation identifies and corrects medication errors that can potentially cause moderate to severe harm. This research sought to identify the impact of pharmacy-led medication reconciliation on patient outcomes and describe the changes in healthcare workers' perceptions of the program. Methods: A pharmacy-led admission medication reconciliation program pilot started in July 2019, and a discharge medication reconciliation proof of concept was tested in September 2020 at a 432-bed hospital. The following periods were compared: August 2018 to February 2019 (pre-program implementation) and August 2019 to February 2020 (post-program implementation). Endpoints included patient outcomes, workforce productivity and interdisciplinary healthcare team satisfaction through program surveys. Patient outcomes were assessed with chisquared tests. Survey responses were assessed using the Likert scale. Descriptive statistics were used for productivity outcomes and the number of discharge medication reconciliations completed. Results: Approximately 18,000 admissions were recorded for each period. The adverse drug event (ADE) rate decreased 49% (p < 0.001), and the complication rate decreased 29.7% (p = 0.001). During post-pilot implementation, 6,530 medication histories were completed, and 70,050 medications were reviewed. Of medication histories completed, 22.6% of patient allergies/adverse drug reactions were updated, 52.3% of medications were clarified, and 54.7% of preferred outpatient pharmacies were updated. Pharmacy services completed medication histories in 38.8% of inpatients. In the proof of concept, 168 discharge medication lists were drafted. Survey results showed statistically significant improvement in healthcare team satisfaction. Conclusion: A pharmacy-led medication reconciliation program involving designated pharmacists and pharmacy technicians has shown to decrease ADEs and complications while improving interdisciplinary healthcare team satisfaction.
