Pharmacist Discharge Medication Reconciliation Study

The Impact of Pharmacist Discharge Medication Reconciliation on Unintentional Medication Discrepancies From Inpatient Discharges at the Alberta Cancer Board Cross Cancer Institute

Status

Completed

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT01226589

Enrollment

Registered

2010-10-22

Start date

2007-10-31

Completion date

2008-10-31

Last updated

2011-04-19

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Medication Reconciliation

Keywords

Cancer cancer, MRS, Treatment response, Histologically confirmed diagnosed Breast cancer., Patient is 18 years or older., Karnofsky performance score is equal to or greater than 70., No previously irradiated or recurrent breast., No contraindication to MRS/MRI.

Brief summary

Adverse drug events can occur commonly due to medication errors during the transition of care in a health care facility. Medication reconciliation is the process of comparing medications and providing an accurate medication list as a resource for prescribers, which is currently only being done upon inpatient admission at the CCI. The purpose of this study is to see if pharmacist medication reconciliation at discharge reduces unintentional medication discrepancies for inpatient discharges.

Interventions

PROCEDUREMRS

Study design

Allocation

RANDOMIZED

Intervention model

SINGLE_GROUP

Primary purpose

TREATMENT

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

* Cancer inpatients under the care of Dr. Follett or Dr. Candler * Cancer inpatients to be discharged from the CCI * Patients \>18 years of age * Patients that are taking \>1 medications or herbals total at home.

Exclusion criteria

* Cancer inpatients that are considered radioactive or in hot rooms (ie. Selectron patients or patients receiving radiation treatment for thyroid) * Patients that do not remain in hospital \>72 hours * Patients without a home phone number or equivalent contact number. * Language barrier (patients unable to speak or understand English). * Patients that are readmitted and already included into the study.

Design outcomes

Primary

Measure	Time frame	Description
MRS Correlation with Treatment Response.	up to 1 year	The percentage of patients with at least one unintentional medication discrepancy after discharge from the Cross Cancer Institute

Secondary

Measure	Time frame	Description
Correlation with Tumor Stage	up to 1 year	The amount of medication discrepancies after discharge that has the potential to cause moderate harm to severe harm.
The frequency of each type of unintentional medication discrepancies.	—	—

Countries

Canada

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026