Evaluation of pharmacist-led medication reconciliation at county hospitals in China: A multicentre, open-label, assessor-blinded, nonrandomised controlled study.

Background: Due to a lack of related research, we aimed to determine the effectiveness of a pharmacist-led medication reconciliation intervention in China. Methods: We conducted a multicentre, prospective, open-label, assessor-blinded, cluster, nonrandomised controlled study at six county-level hospitals, with hospital wards serving as the clusters. We included patients discharged from the sampled hospitals who were aged ≥60 years; had ≥1 studied diagnoses; and were prescribed with ≥3 medications at discharge. Patients in the intervention group received a pharmacist-led medication reconciliation intervention and those in the control group received standard care. We assessed the incidence of medication discrepancies at discharge, patients' medication adherence, and health care utilisation within 30 days after discharge. Results: There were 429 patients in the intervention group (mean age = 72.5 years, standard deviation (SD) = 7.0) and 526 patients in the control group (mean age = 73.6 years, SD = 7.1). Of the 1632 medication discrepancies identified at discharge, fewer occurred in the intervention group (1.9 per patient on average) than the control group (2.6 per patient on average).The intervention significantly reduced the incidence of medication discrepancy by 9.6% (95% confidence interval (CI) = -15.6, -3.6, P = 0.002) and improved patients' medication adherence, with an absolute decrease in the mean adherence score of 2.5 (95% CI = -2.8, -2.2, P < 0.001). There was no significant difference in readmission rates between the intervention and control groups. Conclusions: Pharmacist-led medication reconciliation at discharge from Chinese county-level hospitals reduced medication discrepancies and improved patients' adherence among patients aged 60 years or above, though no impact on readmission after discharge was observed. Registration: ChiCTR2100045668.

Study protocol for the evaluation of pharmacist-participated medication reconciliation at county hospitals in China: a multicentre, open-label, assessor-blinded, non-randomised, controlled study.

INTRODUCTION: Pharmacist-participated medication reconciliation proved an effective strategy to decrease the risk of medication discrepancy-related errors. However, it is still under pilot in China and its effectiveness in the Chinese healthcare system remains unclear. This study aims to conduct a pharmacist-participated medication reconciliation intervention for elderly patients in county hospitals in China and to evaluate its effect. METHODS AND ANALYSIS: This is a multicentre, prospective, open-label, assessor-blinded, cluster, non-randomised, controlled study for elderly patients. The study will be conducted in seven county hospitals, and the clusters will be hospital wards. In each hospital, two internal medicine wards will be randomly allocated into either intervention group or control group. Patients in the intervention group will receive pharmacist-participated medication reconciliation, and those in the control group will receive standard care. The primary outcome is the incidence of medication discrepancy, and the secondary outcomes are patients' medication adherence, healthcare utilisation and medical costs within 30 days after discharge. ETHICS AND DISSEMINATION: Ethics committee approval of this study was obtained from Peking University Institution Review Board (IRB00001052-21016). We have also obtained ethical approvals from all the participating centres. The findings will be published in scientific and conference presentations. TRAIL REGISTRATION NUMBER: ChiCTR2100045668.

Acid Suppression Use Among Infants in One Tertiary Children's Hospital in China, 2015-2018: A Retrospective Observational Study.

Clinical guidelines emphasized that physicians should be cautious when prescribing acid suppressions to infants. Histamine-2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) are not approved for use in infants aged below 2 years in China. We investigated H2RA/PPI use in infants aged below 2 years hospitalized between 1st January 2015 and 31st December 2018 in a Chinese tertiary children's hospital. Our study observed that H2RAs/PPIs were frequently prescribed with a prevalence of 4.4% (7,158/162,192). The frequency of PPI use was over two-fold than that of H2RA use (71.9%, 5,148/7,158; 28.1%, 2,011/7,158). H2RAs/PPIs were commonly used to treat infants without digestive system diseases (57.5%, 4,118/7,158). Further studies are urgently needed to evaluate the effectiveness and safety of H2RAs/PPIs in infants.