Tools for Advancing Pharmacy Practice
Use of a medication reconciliation tool in an outpatient geriatric clinic
Scott Martin Vouri; Zachary A. Marcum
J Am Pharm Assoc (2003) 2013;53:652-658. doi:10.1331/JAPhA.2013.13084
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Scott Martin Vouri: Scott Martin Vouri, PharmD, BCPS, CGP, Assistant Professor, St. Louis College of Pharmacy, St. Louis, MO
Zachary A. Marcum: Zachary A. Marcum, PharmD, MS, BCPS, Assistant Professor, School of Medicine, University of Pittsburgh, Pittsburgh, PA


Objective  To determine whether use of the Medication Reconciliation Review of Systems Subject (MR ROSS) tool is an effective method to identify errors of omission at an initial visit in an outpatient geriatric clinic.

Design  Retrospective chart review.

Setting  Alexian Brothers Community Services (ABCS) Program of All-inclusive Care for the Elderly (PACE), St Louis, MO, from January to December 2012.

Patients  40 patients newly enrolled in ABCS PACE.

Intervention  After the medication evaluation was completed, MR ROSS was used to collect additional medication information to identify errors of omission. Using MR ROSS, the clinical pharmacist asked the patient, “Are you taking anything for [system]?” This line of questioning was continued for every noted area.

Main outcomes measure  Number of patients having an error of omission detected using MR ROSS.

Results  Of the 40 patients, 31 (77.5%) had one or more errors of omission identified by MR ROSS. Of these patients, an average of 4.0 additional medications per patient was identified. Patients with a Mini-Mental State Examination score of 24 or greater were more likely to have an error of omission detected using MR ROSS (P = 0.009). Of the 123 additional medications identified using MR ROSS, 73.2% and 69.9% were nonprescription and as-needed medications, respectively. Of the medications found using MR ROSS, 57%, 17%, and 8.6% were oral medications, topical medications, and oral inhalers, respectively.

Conclusion  Use of the MR ROSS tool was a feasible and effective method to identify errors of omission at an initial visit in an outpatient geriatric clinic.

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