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Volume 20, Issue 1
  • ISSN: 1574-8863
  • E-ISSN: 2212-3911

Abstract

Background

Most studies have focused on the impact of medication reconciliation on one of the points of hospital admission or discharge. In this study, we aimed to investigate the impact of medication reconciliation on medication safety in patients hospitalized with acute decompensated heart failure at both admission and discharge.

Methods

This was a prospective, single-center, cohort study conducted in a tertiary care cardiovascular hospital from December 2022 to May 2023 on patients hospitalized with acute decompensated heart failure. Patients were considered eligible if they were taking at least five chronic medications prior to hospital admission. Medication reconciliation was carried out for the study patients by a clinical pharmacy team both at admission and discharge. Additionally, the study patients also received comprehensive discharge counseling as well as post-discharge follow-up and monitoring.

Results

Medication reconciliation was applied for 129 patients at admission and 118 at discharge. The mean time needed for medication reconciliation presses was 32 min per patient at admission and 22 min at discharge. Unintentional medication discrepancies were relatively common at both admission and discharge, but compared to admission, discrepancies were less frequent at discharge (178 72). Based on the consensus review, about 30% of identified errors detected at both admission and discharge were judged to have the potential to cause moderate to severe harm to the patient. Most of the clinical pharmacists’ recommendations on unintended discrepancies were accepted by physicians and resulted in changes in medication orders (more than 80%). Further, the majority of the participants were ‘very satisfied’ or ‘satisfied’ with the clinical pharmacy services provided to them during hospitalization and after hospital discharge (89.90%).

Conclusion

Our results demonstrated the vulnerability of heart failure patients to medication discrepancies at both admission and discharge. Thus, implementing a comprehensive medication reconciliation by clinical pharmacists could be beneficial for enhancing medication safety in these patients.

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2025-07-10

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References

  1. BatesD.W. SpellN. CullenD.J. BurdickE. LairdN. PetersenL.A. SmallS.D. SweitzerB.J. LeapeL.L. Adverse Drug Events Prevention Study Group The costs of adverse drug events in hospitalized patients.JAMA1997277430731110.1001/jama.1997.035402800450329002493
     [Google Scholar]
  2. La PietraL. CalligarisL. MolendiniL. QuattrinR. BrusaferroS. Medical errors and clinical risk management: State of the art.Acta Otorhinolaryngol. Ital.200525633934616749601
     [Google Scholar]
  3. BrennanT.A. LeapeL.L. LairdN.M. HebertL. LocalioA.R. LawthersA.G. NewhouseJ.P. WeilerP.C. HiattH.H. Incidence of adverse events and negligence in hospitalized patients. Results of the harvard medical practice study I.N. Engl. J. Med.1991324637037610.1056/NEJM1991020732406041987460
     [Google Scholar]
  4. BatesD.W. CullenD.J. LairdN. PetersenL.A. SmallS.D. ServiD. LaffelG. SweitzerB.J. SheaB.F. HalliseyR. ADE Prevention Study Group Incidence of adverse drug events and potential adverse drug events. Implications for prevention.JAMA19952741293410.1001/jama.1995.035300100430337791255
     [Google Scholar]
  5. AndelC. DavidowS.L. HollanderM. MorenoD.A. The economics of health care quality and medical errors.J. Health Care Finance2012391395023155743
     [Google Scholar]
  6. LeapeL.L. BatesD.W. CullenD.J. CooperJ. DemonacoH.J. GallivanT. HalliseyR. IvesJ. LairdN. LaffelG. ADE Prevention Study Group Systems analysis of adverse drug events.JAMA19952741354310.1001/jama.1995.035300100490347791256
     [Google Scholar]
  7. RozichJ.D. HowardR.J. JustesonJ.M. MackenP.D. LindsayM.E. ResarR.K. Standardization as a mechanism to improve safety in health care.Jt. Comm. J. Qual. Saf.200430151410.1016/S1549‑3741(04)30001‑814738031
     [Google Scholar]
  8. HughesR Patient safety and quality: An evidence-based handbook for nurses.Rockville (MD): Agency for Healthcare Research and Quality2008
     [Google Scholar]
  9. BarnsteinerJH Medication reconciliation.Patient safety and quality: an evidence-based handbook for nurses2008
     [Google Scholar]
  10. UlrichB. KearT. Patient safety and patient safety culture: Foundations of excellent health care delivery.Nephrol. Nurs. J.201441544745626295088
     [Google Scholar]
  11. Improvement IfHHow-to guide: prevent adverse drug events by implementing medication reconciliation.2001
     [Google Scholar]
  12. MuellerS.K. SponslerK.C. KripalaniS. SchnipperJ.L. Hospital based medication reconciliation practices: A systematic review.Arch. Intern. Med.2012172141057106910.1001/archinternmed.2012.224622733210
     [Google Scholar]
  13. MekonnenA.B. McLachlanA.J. BrienJ.E. Pharmacy-led medication reconciliation programmes at hospital transitions: a systematic review and meta-analysis.J. Clin. Pharm. Ther.201641212814410.1111/jcpt.1236426913812
     [Google Scholar]
  14. ThompsonK.K. Medication reconciliation: Challenges and opportunities.Am. J. Health Syst. Pharm.200764181912191210.2146/ajhp06062217823101
     [Google Scholar]
  15. WalravenC. SethR. AustinP.C. LaupacisA. Effect of discharge summary availability during post-discharge visits on hospital readmission.J. Gen. Intern. Med.200217318619210.1046/j.1525‑1497.2002.10741.x11929504
     [Google Scholar]
  16. KripalaniS JacksonAT SchnipperJL ColemanEA Promoting effective transitions of care at hospital discharge: A review of key issues for hospitalists.J Hosp Med.20072531432310.1002/jhm.228
     [Google Scholar]
  17. ForsterA.J. MurffH.J. PetersonJ.F. GandhiT.K. BatesD.W. The incidence and severity of adverse events affecting patients after discharge from the hospital.Ann. Intern. Med.2003138316116710.7326/0003‑4819‑138‑3‑200302040‑0000712558354
     [Google Scholar]
  18. CuaY.M. KripalaniS. Medication use in the transition from hospital to home.Ann. Acad. Med. Singap.200837213614110.47102/annals‑acadmedsg.V37N2p13618327350
     [Google Scholar]
  19. WilsonS. RuscoeW. ChapmanM. MillerR. General practitioner–hospital communications: A review of discharge summaries.J. Qual. Clin. Pract.200121410410810.1046/j.1440‑1762.2001.00430.x11856404
     [Google Scholar]
  20. KripalaniS. LeFevreF. PhillipsC.O. WilliamsM.V. BasaviahP. BakerD.W. Deficits in communication and information transfer between hospital-based and primary care physicians: Implications for patient safety and continuity of care.JAMA2007297883184110.1001/jama.297.8.83117327525
     [Google Scholar]
  21. GrimesT.C. DugganC.A. DelaneyT.P. GrahamI.M. ConlonK.C. DeasyE. Jago-ByrneM.C. O’ BrienP. Medication details documented on hospital discharge: Cross‐sectional observational study of factors associated with medication non‐reconciliation.Br. J. Clin. Pharmacol.201171344945710.1111/j.1365‑2125.2010.03834.x21284705
     [Google Scholar]
  22. GlintborgB. AndersenS.E. DalhoffK. Insufficient communication about medication use at the interface between hospital and primary care.Qual. Saf. Health Care2007161343910.1136/qshc.2006.01982817301202
     [Google Scholar]
  23. WongJ.D. BajcarJ.M. WongG.G. AlibhaiS.M.H. HuhJ.H. CestaA. PondG.R. FernandesO.A. Medication reconciliation at hospital discharge: Evaluating discrepancies.Ann. Pharmacother.200842101373137910.1345/aph.1L19018780806
     [Google Scholar]
  24. Leguelinel-BlacheG. ArnaudF. BouvetS. DuboisF. CastelliC. Roux-MarsonC. RayV. SottoA. KinowskiJ.M. Impact of admission medication reconciliation performed by clinical pharmacists on medication safety.Eur. J. Intern. Med.201425980881410.1016/j.ejim.2014.09.01225277510
     [Google Scholar]
  25. KaraouiL.R. ChamounN. FakhirJ. Abi GhanemW. DroubiS. Diab MarzoukA.R. DroubiN. MasriH. RamiaE. Impact of pharmacy-led medication reconciliation on admission to internal medicine service: Experience in two tertiary care teaching hospitals.BMC Health Serv. Res.201919149310.1186/s12913‑019‑4323‑731311537
     [Google Scholar]
  26. AbdulghaniK.H. AseeriM.A. MahmoudA. AbulezzR. The impact of pharmacist-led medication reconciliation during admission at tertiary care hospital.Int. J. Clin. Pharm.201840119620110.1007/s11096‑017‑0568‑629248986
     [Google Scholar]
  27. AbrashkinK.A. ChoH.J. TorgalkarS. MarkoffB. Improving transitions of care from hospital to home: What works?Mt. Sinai J. Med.201279553554410.1002/msj.2133222976359
     [Google Scholar]
  28. UlayarAS LópezSG LlobetNP SanchoAM BernadàsLC MéndezRM Pharmaceutical intervention upon hospital discharge to strengthen understanding and adherence to pharmacological treatment.Farm Hosp2012363118123
     [Google Scholar]
  29. Karapinar-ÇArkitF. BorgsteedeS.D. ZoerJ. SmitH.J. EgbertsA.C. BemtP.M.V.D. Effect of medication reconciliation with and without patient counseling on the number of pharmaceutical interventions among patients discharged from the hospital.Ann. Pharmacother.20094361001101010.1345/aph.1L59719491320
     [Google Scholar]
  30. MurphyE.M. OxencisC.J. KlauckJ.A. MeyerD.A. ZimmermanJ.M. Medication reconciliation at an academic medical center: Implementation of a comprehensive program from admission to discharge.Am. J. Health Syst. Pharm.200966232126213110.2146/ajhp08055219923314
     [Google Scholar]
  31. UnroeK.T. PfeiffenbergerT. RiegelhauptS. JastrzembskiJ. LokhnyginaY. Colón-EmericC. Inpatient medication reconciliation at admission and discharge: A retrospective cohort study of age and other risk factors for medication discrepancies.Am. J. Geriatr. Pharmacother.20108211512610.1016/j.amjopharm.2010.04.00220439061
     [Google Scholar]
  32. Belda-RustarazoS. Cantero-HinojosaJ. Salmeron-GarcíaA. González-GarcíaL. Cabeza-BarreraJ. GalvezJ. Medication reconciliation at admission and discharge: an analysis of prevalence and associated risk factors.Int. J. Clin. Pract.201569111268127410.1111/ijcp.1270126202091
     [Google Scholar]
  33. AlghamdiD.S. AlhrasenM. KassemA. AlwagdaniA. TourkmaniA.M. AlnowaiserN. Al BarakahY. AlotaibiY.K. Implementation of medication reconciliation at admission and discharge in Ministry of Defense Health Services hospitals: A multicentre study.BMJ Open Qual.2023122e00212110.1136/bmjoq‑2022‑00212137308255
     [Google Scholar]
  34. FernandesO. ShojaniaK. Medication reconciliation in the hospital: What, why, where, when, who and how?Healthc. Q.201215sp424910.12927/hcq.2012.2284222874446
     [Google Scholar]
  35. RasoolM.F. RehmanA. ImranI. AbbasS. ShahS. AbbasG. KhanI. ShakeelS. Ahmad HassaliM.A. HayatK. Risk factors associated with medication errors among patients suffering from chronic disorders.Front. Public Health2020853103810.3389/fpubh.2020.53103833330300
     [Google Scholar]
  36. PippinsJ.R. GandhiT.K. HamannC. NdumeleC.D. LabonvilleS.A. DiedrichsenE.K. CartyM.G. KarsonA.S. BhanI. ColeyC.M. LiangC.L. TurchinA. McCarthyP.C. SchnipperJ.L. Classifying and predicting errors of inpatient medication reconciliation.J. Gen. Intern. Med.20082391414142210.1007/s11606‑008‑0687‑918563493
     [Google Scholar]
  37. JaarsmaT. Haaijer-RuskampF.M. SturmH. Van VeldhuisenD.J. Management of heart failure in The Netherlands.Eur. J. Heart Fail.20057337137510.1016/j.ejheart.2005.01.00715718177
     [Google Scholar]
  38. MzaleA.M. Incidence and types of medication errors in the management of Inpatients with chronic cardiac failure at Muhimbili National Hospital Dar Es Salaam.Muhimbili University of Health and Allied Sciences2012
     [Google Scholar]
  39. Abou-KaramN. BradfordC. LorK.B. BarnettM. HaM. RizosA. Medication regimen complexity and readmissions after hospitalization for heart failure, acute myocardial infarction, pneumonia, and chronic obstructive pulmonary disease.SAGE Open Med.2016410.1177/205031211663242626985392
     [Google Scholar]
  40. EgginkR.N. LenderinkA.W. WiddershovenJ.W.M.G. BemtP.M.L.A. The effect of a clinical pharmacist discharge service on medication discrepancies in patients with heart failure.Pharm. World Sci.201032675976610.1007/s11096‑010‑9433‑620809276
     [Google Scholar]
  41. MagalhãesG.F. SantosG.B.N.C. RosaM.B. NoblatL.A.C.B. Medication reconciliation in patients hospitalized in a cardiology unit.PLoS One2014912e11549110.1371/journal.pone.011549125531902
     [Google Scholar]
  42. NacharC. LamyO. SadeghipourF. GarnierA. VoirolP. Medication reconciliation in a Swiss hospital: Methods, benefits and pitfalls.Eur. J. Hosp. Pharm. Sci. Pract.201926312913410.1136/ejhpharm‑2017‑00135831428319
     [Google Scholar]
  43. PonniahA. AndersonB. ShakibS. DoeckeC.J. AngleyM. Pharmacists? role in the post-discharge management of patients with heart failure: A literature review.J. Clin. Pharm. Ther.200732434335210.1111/j.1365‑2710.2007.00827.x17635336
     [Google Scholar]
  44. Milfred-LaForestS.K. GeeJ.A. PugaczA.M. PiñaI.L. HooverD.M. WenzellR.C. FeltonA. GuttenbergE. OrtizJ. Heart failure transitions of care: A pharmacist-led post-discharge pilot experience.Prog. Cardiovasc. Dis.201760224925810.1016/j.pcad.2017.08.00528826670
     [Google Scholar]
  45. WardenB.A. FreelsJ.P. FurunoJ.P. MackayJ. Pharmacy-managed program for providing education and discharge instructions for patients with heart failure.Am. J. Health Syst. Pharm.201471213413910.2146/ajhp13010324375606
     [Google Scholar]
  46. LeotsakosA. ZhengH. CroteauR. LoebJ.M. ShermanH. HoffmanC. MorgansteinL. O’LearyD. BruneauC. LeeP. DuguidM. ThomeczekC. Schrieck-De LoosE. MunierB. Standardization in patient safety: The WHO High 5s project.Int. J. Qual. Health Care201426210911610.1093/intqhc/mzu01024713313
     [Google Scholar]
  47. CornishP.L. KnowlesS.R. MarchesanoR. TamV. ShadowitzS. JuurlinkD.N. EtchellsE.E. Unintended medication discrepancies at the time of hospital admission.Arch. Intern. Med.2005165442442910.1001/archinte.165.4.42415738372
     [Google Scholar]
  48. LeeS. GodwinO.P. KimK. LeeE. Predictive factors of patient satisfaction with pharmacy services in South Korea: A cross-sectional study of national level data.PLoS One20151011e014226910.1371/journal.pone.014226926540165
     [Google Scholar]
  49. AhmadimoghaddamD. MehrpooyaM. KhoramiM-R. MohammadiM. MohammadiY. Clinical pharmacists’ contribution to medication reconciliation in outpatient specialty clinics in iran.Curr. Drug Saf.202217325926810.2174/157488631666621112310100234814820
     [Google Scholar]
  50. OrganizationW.H. Medication safety in transitions of care: technical report.World Health Organization2019
     [Google Scholar]
  51. StarkH.E. GraudinsL.V. McGuireT.M. LeeC.Y.Y. DuguidM.J. Implementing a sustainable medication reconciliation process in Australian hospitals: The world health organization high 5s project.Res. Social Adm. Pharm.202016329029810.1016/j.sapharm.2019.05.01131176651
     [Google Scholar]
  52. CornuP. SteurbautS. LeysenT. BaereE.D. LigneelC. MetsT. DupontA.G. Effect of medication reconciliation at hospital admission on medication discrepancies during hospitalization and at discharge for geriatric patients.Ann. Pharmacother.201246448449410.1345/aph.1Q59422414793
     [Google Scholar]
  53. GeurtsM.M.E. van der FlierM. de Vries-BotsA.M.B. Brink-van der WalT.I.C. de GierJ.J. Medication reconciliation to solve discrepancies in discharge documents after discharge from the hospital.Int. J. Clin. Pharm.201335460060710.1007/s11096‑013‑9776‑x23595915
     [Google Scholar]
  54. DongP.T.X. PhamV.T.T. NguyenT.T. NguyenH.T.L. HuaS. LiS.C. Unintentional medication discrepancies at admission among elderly inpatients with chronic medical conditions in Vietnam: A single-centre observational study.Drugs Real World Outcomes20229114115110.1007/s40801‑021‑00274‑334586593
     [Google Scholar]
  55. MakaryusA.N. FriedmanE.A. Patients’ understanding of their treatment plans and diagnosis at discharge.In: Mayo clinic proceedings: 2005.Elsevier200599199410.4065/80.8.991
     [Google Scholar]
  56. Climente-MartíM. García-MañónE.R. Artero-MoraA. Jiménez-TorresN.V. Potential risk of medication discrepancies and reconciliation errors at admission and discharge from an inpatient medical service.Ann. Pharmacother.201044111747175410.1345/aph.1P18420923946
     [Google Scholar]
  57. VarkeyP. CunninghamJ. O’MearaJ. BonacciR. DesaiN. SheelerR. Multidisciplinary approach to inpatient medication reconciliation in an academic setting.Am. J. Health Syst. Pharm.200764885085410.2146/ajhp06031417420202
     [Google Scholar]
  58. ForsterA.J. MurffH.J. PetersonJ.F. GandhiT.K. BatesD.W. Adverse drug events occurring following hospital discharge.J. Gen. Intern. Med.200520431732310.1111/j.1525‑1497.2005.30390.x15857487
     [Google Scholar]
  59. MichaelsenM. McCagueP. BradleyC. SahmL. Medication reconciliation at discharge from hospital: a systematic review of the quantitative literature.Pharmacy201532537110.3390/pharmacy302005328975903
     [Google Scholar]
  60. CrottyM. RowettD. SpurlingL. GilesL.C. PhillipsP.A. Does the addition of a pharmacist transition coordinator improve evidence-based medication management and health outcomes in older adults moving from the hospital to a long-term care facility? Results of a randomized, controlled trial.Am. J. Geriatr. Pharmacother.20042425726410.1016/j.amjopharm.2005.01.00115903284
     [Google Scholar]
  61. DudasV. BookwalterT. KerrK.M. PantilatS.Z. The impact of follow-up telephone calls to patients after hospitalization.Am. J. Med.20011119263010.1016/S0002‑9343(01)00966‑411790365
     [Google Scholar]
  62. BajeuxE. AlixL. CornéeL. BarbazanC. MercerolleM. HowlettJ. CruveilhierV. Liné-IehlC. CadorB. JegoP. GicquelV. SchweyerF.X. MarieV. HamonicS. JosselinJ.M. SommeD. HueB. Pharmacist-led medication reconciliation at patient discharge: A tool to reduce healthcare utilization? an observational study in patients 65 years or older.BMC Geriatr.202222157610.1186/s12877‑022‑03192‑335831783
     [Google Scholar]
  63. UrbanR. ArmitageG. MorganJ. MarshallK. BlenkinsoppA. ScallyA. Custom and practice: A multi-center study of medicines reconciliation following admission in four acute hospitals in the UK.Res. Social Adm. Pharm.201410235536810.1016/j.sapharm.2013.06.00924529643
     [Google Scholar]
  64. McCulloughP.A. PhilbinE.F. SpertusJ.A. KaatzS. SandbergK.R. WeaverW.D. Resource Utilization Among Congestive Heart Failure (REACH) Study Confirmation of a heart failure epidemic: Findings from the resource utilization among congestive heart failure (REACH) study.J. Am. Coll. Cardiol.2002391606910.1016/S0735‑1097(01)01700‑411755288
     [Google Scholar]
  65. LisbyM. NielsenL.P. MainzJ. Errors in the medication process: Frequency, type, and potential clinical consequences.Int. J. Qual. Health Care2005171152210.1093/intqhc/mzi01515668306
     [Google Scholar]
  66. PaiboonvongT. MontakantikulP. ChansirkarnjanaS. TrangulpiankitP. Incidence of medication errors in medication reconciliation at general medical wards, Ramathibodi hospital.J. Pharm. Sci.200936444920
     [Google Scholar]
  67. TamV.C. KnowlesS.R. CornishP.L. FineN. MarchesanoR. EtchellsE.E. Frequency, type and clinical importance of medication history errors at admission to hospital: A systematic review.CMAJ2005173551051510.1503/cmaj.04531116129874
     [Google Scholar]
  68. FitzGeraldR.J. Medication errors: The importance of an accurate drug history.Br. J. Clin. Pharmacol.200967667167510.1111/j.1365‑2125.2009.03424.x19594536
     [Google Scholar]
  69. Rodríguez VargasB. Delgado SilveiraE. Iglesias PeinadoI. Bermejo VicedoT. Prevalence and risk factors for medication reconciliation errors during hospital admission in elderly patients.Int. J. Clin. Pharm.20163851164117110.1007/s11096‑016‑0348‑827558355
     [Google Scholar]
  70. PayneR.A. AveryA.J. Polypharmacy: One of the greatest prescribing challenges in general practice.Br. J. Gen. Pract.201161583838410.3399/bjgp11X55614621276330
     [Google Scholar]
  71. SassoF.C. SimeonV. GalieroR. CaturanoA. De NicolaL. ChiodiniP. RinaldiL. SalvatoreT. LettieriM. NevolaR. SarduC. DocimoG. LoffredoG. MarfellaR. AdinolfiL.E. MinutoloR. AmeliaU. AciernoC. CalatolaP. CarbonaraO. ConteG. CoriglianoG. CoriglianoM. D’UrsoR. De MatteoA. De NicolaL. De RosaN. Del VecchioE. Di GiovanniG. GattiA. GentileS. GesuèL. ImprotaL. LampitellaJrA. LampitellaA. LanzilliA. LascarN. MasiS. MatteiP. MastrilliV. MemoliP. MinutoloR. NastiR. PaganoA. PentangeloM. PisaE. RossiE. SassoF.C. SorrentinoS. TorellaR. TroiseR. TrucilloP. TurcoA.A. TurcoS. ZibellaF. ZirpoliL. NID-2 study group Investigators The number of risk factors not at target is associated with cardiovascular risk in a type 2 diabetic population with albuminuria in primary cardiovascular prevention. Post-hoc analysis of the NID-2 trial.Cardiovasc. Diabetol.202221123510.1186/s12933‑022‑01674‑736344978
     [Google Scholar]
  72. GuideH-t. Prevent Adverse Drug Events by Implementing Medication Reconciliation.Cambridge, MA: Institute for Healthcare Improvement2011
     [Google Scholar]
  73. JacobiJ. Clinical pharmacists: Practitioners who are essential members of your clinical care team.Rev. Med. Clin. Las Condes201627557157710.1016/j.rmclc.2016.09.002
     [Google Scholar]
  74. FrancisJ. AbrahamS. Clinical pharmacists: Bridging the gap between patients and physicians.Saudi Pharm. J.201422660060210.1016/j.jsps.2014.02.01125561874
     [Google Scholar]
  75. AndreoliL. AlexandraJ.F. TesmoingtC. EerdekensC. MacrezA. PapoT. ArnaudP. PapyE. Medication reconciliation: A prospective study in an internal medicine unit.Drugs Aging201431538739310.1007/s40266‑014‑0167‑324659397
     [Google Scholar]
  76. AronsonJ.K. Medication errors: Definitions and classification.Br. J. Clin. Pharmacol.200967659960410.1111/j.1365‑2125.2009.03415.x19594526
     [Google Scholar]
  77. BaseyA.J. KrskaJ. KennedyT.D. MackridgeA.J. Prescribing errors on admission to hospital and their potential impact: A mixed-methods study.BMJ Qual. Saf.2014231172510.1136/bmjqs‑2013‑00197823922405
     [Google Scholar]
/content/journals/cds/10.2174/0115748863284257231212063959
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Impact of Clinical Pharmacist-conducted Medication Reconciliation at Admission and Discharge on Medication Safety in Patients Hospitalized with Acute Decompensated Heart Failure
Curr Drug Saf 20, 56 (2025); https://doi.org/10.2174/0115748863284257231212063959
/content/journals/cds/10.2174/0115748863284257231212063959
/content/journals/cds/10.2174/0115748863284257231212063959
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  • Article Type:     Research Article
Keyword(s): acute decompensated heart failure; clinical pharmacy; hospital admission; hospital discharge; medication discrepancy; Medication reconciliation; medication safety

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