According to Institute for Safe Medication Practices Canada (ISMP Canada), medication reconciliation is the process by which healthcare providers work together with patients, families, and care providers to ensure accurate and comprehensive medication information is communicated consistently across all transitions of care. Medication reconciliation requires a systematic and comprehensive review of all the medications a patient is taking. This ensures that medications which are being added, changed, or discontinued are carefully evaluated. It is a component of medication management and will inform and enable prescribers to make the most appropriate prescribing decisions for the patient.
An adverse drug event is an injury or harm which is associated with a given medicine or lack of an intended medicine. Adverse drug events can occur even when given a normal dosage as it is possible that certain drugs cause harm when given together. Adverse drug events can be prevented if an extensive medication list is taken when a patient enters the hospital as physicians can take all medications into consider before prescribing.
A best possible medication history (BPMH) is a list of medications (prescribed and non-prescribed) that a patient is currently taking. The BPMH can be created from interviewing the patient/family; as well as reviewing at least one other reliable source of information (often, a patient’s pharmacy). Complete documentation, including drug name, dosage, route, and frequency is needed. The BPMH can then be used in the hospital to help physicians decide which medications to add, change, or discontinue.
The respect of the privacy of study participants and the confidentiality of personal information is a priority. Dr. Tamblyn and her research team use proven secure technologies. Once an eligible patient gives written consent, the patient’s nurses, pharmacists, and physicians at the hospital will have access to his/her medication history. This access is made possible through the RightRx software, which has a secure link to the administrative databases of the RAMQ. A detailed record is kept whenever a clinician accesses the RAMQ medication information for a patient. Only clinicians who have permission to use the existing hospital computer systems to access patient information will be able to use RightRx.
Data is stored on the server for the RightRx research program. The hospital uses a secure (HTTPS) connection to connect to the RightRx server. Access to the server is limited and has the latest and most sophisticated protection.
The data collected from the study will be used to predict adverse drug events and to provide physicians with information to compare the safety and effectiveness of various prescription medications.
The patient consent form contains enough information for individuals to make an informed, voluntary decision when they decide to allow clinicians to access their information. All participants have the right to withdraw from the study at any time by contacting the research team. As soon as they withdraw from the project, all transfer of that person's information is stopped and there is no penalty for ending participation. The normal services and standard of care will continue to be available to both consenting and non-consenting patients.
The RightRx program has been reviewed and approved by the Commission d’accès à l’information du Québec, the MUHC RI Research Ethics Board and the McGill University Health Centre’s ethics committee. The project respects the current standards and laws governing computerized prescribing.