The Impact Of Clinical Pharmacists Medication Reconciliation Upon Patients Admission To Reduce Medication Discrepancies.

A Comparative Prospective Interventional Study Shows The Impact Of The Clinical Pharmacists' Role In The Emergency Department In Medication Reconciliation Upon Patients' Admission To Reduce The Medication Discrepancies.

It is a quazai one arm study shows the impact of the role of the clinical pharmacists through medication reconciliation to patients admitted to the emergency department .The main aim is to show if the pharmacists intervention is associated with establishing a complete drug history list than the list already presented in the patient file and taken by the physician .Then a description of the medication errors detected will be done .

It is a quazai one arm study in which the pre phase is the detection of the complete and accurate drug history list already presented in the patient file and taken by the physician and the post phase is the detection of the complete and accurate drug history list taken by the clinical pharmacists after medication reconciliation for the same patients.

medication reconciliation will be done as a full diseases and preadmission medications history will be taken from the patients or the family through interviews, revising previous prescriptions and hospital records.

• Preadmission medication history will include medications trade names, doses, frequency and route of administration and treatment duration and also will include the consumption of vitamins or herbs.
• The medication errors will be detected ,calculated and classified according to medication at transitions and clinical handoffs (MATCH) toolkit for medication reconciliation and NCC MERP index.

Inclusion Criteria:

• Patients with one or more chronic disease / drug.

Exclusion Criteria:

- Patients who cannot communicate or have no family members.