Your Guide to Medication Reconciliation (+ Why It Benefits Your Patients)

January 11, 2022 by Antonio Arias, MBA, CHBME

Topics: Practice Management

One of the advances of modern medicine is that of improved medication performance and safer usage for patients. However, it’s still crucial to know what medication history a patient has before prescribing them a new medication as part of their treatment plan.

That’s where the process of medication reconciliation comes into play: this methodology ensures that both patient and provider are on the same page about past, present, and potential future medications.

What Is Medication Reconciliation?

Medication reconciliation is the process of vetting all medications a patient has a history of taking in relation to the medication they’re being prescribed. This process is an important part of patient care because it takes into account all pertinent medications while determining which medications to prescribe in the future.

Compiling a comprehensive list of what the patient has been taking is key to knowing if there might be any dangerous interactions with medications the provider is considering as part of a treatment plan.

A comprehensive list of medications might include:

  • All prescription medications
  • Vitamins, nutritional, and herbal supplements
  • Over-the-counter (OTC) drugs
  • Vaccines
  • Diagnostic and contrast agents
  • Parenteral nutrition
  • Blood derivatives
  • IV solutions

Even if you don’t consider vitamins or OTC drugs to technically be medications, there could still be interactions between them and new medications introduced to the patient. Therefore, it’s important to collect this information.

There are a few steps to completing the patient medication reconciliation process, including the following:

Determine a Clear Time Frame for Completion

Some medical organizations have established a process that reviews the patients’ medication list at every primary care visit and within 24 hours of inpatient admission.

Another consideration for establishing an explicit time frame for medication reconciliation completion is to have awareness of the patient’s potential high-risk medications such as antihypertensives, anti-seizure medications, and antibiotics.

Verify Medications


This step involves collecting the patient’s medication information. Anything included in the bullet points above—and anything that might be relevant for you to know as the provider—should be documented. Any and all patient medications will help inform you of the current state of the patient and provide insight into their health from another perspective.

Clarify Dosages and Other Qualities of Medications

Once you’ve acquired all medications, supplements, and other pertinent information during the verification process, you need to clarify these medications. That means double-checking that the dosages listed are appropriate for the patient and relevant for achieving their health goals in relation to a treatment plan.

Clarifying that all medications are at the appropriate dosage is also another layer in ensuring patient safety since incorrect dosages could be useless or harmful in the long run.

Reconcile Any Potential Interactions

The reconciliation step involves making any changes that are needed for the patient and their treatment plan.

This part of medication reconciliation also entails considering adding medications to the patient’s current regimen and what the potential interactions or consequences of additional medications might be on the patient’s wellbeing. It’s vital that all medications are taken into account here so as to best ensure no duplications or dosing errors are perpetuated.

Design and Establish a Medication Monitoring Process

To provide the best care over time, be sure to create a reconciliation process of open and/or closed patient records to routinely monitor how medications might be performing over time.

Updating medication records when needed is helpful to tracking patient health and how well the treatment plan is working. Plus, it’s a good chance to discuss new medications on the market that might perform better than a current medication.

What Is the Purpose of Medication Reconciliation?

Medication reconciliation is done to avoid medication errors such as omissions, duplications, dosing errors, or drug interactions. Each health care setting needs to develop standards for who is responsible and how the process will be completed.

It should be done at every transition of care in which new medications are ordered or existing orders are rewritten. With a clear and established medication reconciliation process, your patients are significantly less likely to experience a harmful medication interaction. That’s why it’s important to have a thorough understanding of previous, current, and future medications for the patient when determining a treatment plan.

How Does Medication Reconciliation Benefit Your Patients?

Medication reconciliation benefits your patients in a few ways, including the following factors:

Improves Safety

The ultimate purpose of medication reconciliation is to prioritize patient safety and overall wellbeing in relation to medication and supplements they might take.

Research shows that the average hospitalized patient is subject to at least one medication error per day, which confirms previous research findings that medication errors represent the most common patient safety error. Wholly preventing negative consequences due to medications or adverse drug events (ADEs) remains a top patient safety goal in all healthcare settings

Increases Transparency Regarding Medications

When your patients are asked about every type of medication they’re taking and all the pertinent details about them, it helps them engage in their own wellness journey. Medication reconciliation is important because patient engagement empowers the individual being treated to understand how medications interact and how medications play a role in their treatment plan.

Boosting overall transparency related to medications keeps the patient involved and empowered about their health.

Comprehensive Data for Better Treatments

A plethora of factors—such as patients’ lack of knowledge of their medications, physician and nurse transitions, and lack of integration of patient health records across the spectrum of care—all contribute to a lack of a complete medication reconciliation, which in turn creates the potential for error.

With medication reconciliation processes repeating over time, patients can gather relevant information regarding their medications, resulting in comprehensive data for better treatment plans.

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