↓ Skip to main content

What works in medication reconciliation: an on-treatment and site analysis of the MARQUIS2 study

Overview of attention for article published in BMJ Quality & Safety, March 2023
Altmetric Badge

About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • Among the highest-scoring outputs from this source (#36 of 2,551)
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (95th percentile)

Mentioned by

news
37 news outlets
blogs
1 blog
twitter
25 X users

Citations

dimensions_citation
5 Dimensions

Readers on

mendeley
15 Mendeley
You are seeing a free-to-access but limited selection of the activity Altmetric has collected about this research output. Click here to find out more.
Title
What works in medication reconciliation: an on-treatment and site analysis of the MARQUIS2 study
Published in
BMJ Quality & Safety, March 2023
DOI 10.1136/bmjqs-2022-014806
Pubmed ID
Authors

Jeffrey L Schnipper, Harry Reyes Nieva, Catherine Yoon, Meghan Mallouk, Amanda S Mixon, Stephanie Rennke, Eugene S Chu, Stephanie K Mueller, G Randy Smith, Mark V Williams, Tosha B Wetterneck, Jason Stein, Anuj K Dalal, Stephanie Labonville, Anirudh Sridharan, Deonni P Stolldorf, Endel John Orav, Marcus Gresham, Jenna Goldstein, Sara Platt, Christopher Tugbéh Nyenpan, Eric Howell, Sunil Kripalani

Abstract

The second Multicenter Medication Reconciliation Quality Improvement Study demonstrated a marked reduction in medication discrepancies per patient. The aim of the current analysis was to determine the association of patient exposure to each system-level intervention and receipt of each patient-level intervention on these results. This study was conducted at 17 North American Hospitals, the study period was 18 months per site, and sites typically adopted interventions after 2-5 months of preintervention data collection. We conducted an on-treatment analysis (ie, an evaluation of outcomes based on patient exposure) of system-level interventions, both at the category level and at the individual component level, based on monthly surveys of implementation site leads at each site (response rate 65%). We then conducted a similar analysis of patient-level interventions, as determined by study pharmacist review of documented activities in the medical record. We analysed the association of each intervention on the adjusted number of medication discrepancies per patient in admission and discharge orders, based on a random sample of up to 22 patients per month per site, using mixed-effects Poisson regression with hospital site as a random effect. We then used a generalised linear mixed-effects model (GLMM) decision tree to determine which patient-level interventions explained the most variance in discrepancy rates. Among 4947 patients, patient exposure to seven of the eight system-level component categories was associated with modest but significant reductions in discrepancy rates (adjusted rate ratios (ARR) 0.75-0.97), as were 15 of the 17 individual system-level intervention components, including hiring, reallocating and training personnel to take a best possible medication history (BPMH) and training personnel to perform discharge medication reconciliation and patient counselling. Receipt of five of seven patient-level interventions was independently associated with large reductions in discrepancy rates, including receipt of a BPMH in the emergency department (ED) by a trained clinician (ARR 0.40, 95% CI 0.37 to 0.43), admission medication reconciliation by a trained clinician (ARR 0.57, 95% CI 0.50 to 0.64) and discharge medication reconciliation by a trained clinician (ARR 0.64, 95% CI 0.57 to 0.73). In GLMM decision tree analyses, patients who received both a BPMH in the ED and discharge medication reconciliation by a trained clinician experienced the lowest discrepancy rates (0.08 per medication per patient). Patient-level interventions most associated with reductions in discrepancies were receipt of a BPMH of admitted patients in the ED and admission and discharge medication reconciliation by a trained clinician. System-level interventions were associated with modest reduction in discrepancies for the average patient but are likely important to support patient-level interventions and may reach more patients. These findings can be used to help hospitals and health systems prioritise interventions to improve medication safety during care transitions.

X Demographics

X Demographics

The data shown below were collected from the profiles of 25 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 15 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 15 100%

Demographic breakdown

Readers by professional status Count As %
Other 4 27%
Student > Master 1 7%
Unspecified 1 7%
Lecturer 1 7%
Student > Doctoral Student 1 7%
Other 3 20%
Unknown 4 27%
Readers by discipline Count As %
Pharmacology, Toxicology and Pharmaceutical Science 3 20%
Medicine and Dentistry 3 20%
Business, Management and Accounting 2 13%
Unspecified 1 7%
Social Sciences 1 7%
Other 1 7%
Unknown 4 27%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 296. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 January 2024.
All research outputs
#118,018
of 25,400,630 outputs
Outputs from BMJ Quality & Safety
#36
of 2,551 outputs
Outputs of similar age
#3,063
of 422,003 outputs
Outputs of similar age from BMJ Quality & Safety
#2
of 21 outputs
Altmetric has tracked 25,400,630 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,551 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 30.9. This one has done particularly well, scoring higher than 98% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 422,003 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 21 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 95% of its contemporaries.