OBJECTIVE: To determine the number of discrepancies and medication-related problems found as a result of pharmacy-led medication reconciliation involving introductory pharmacy practice experience (IPPE) students at a comprehensive @entity5 center. SETTING: Outpatient infusion center of a National @entity5 Institute (NCI)-designated and National @entity5 center. PRACTICE DESCRIPTION AND INNOVATION: Third-year IPPE students contacted and completed medication reconciliation for 510 hematology/oncology @entity1 scheduled for infusion center appointments without a coupled provider visit. IPPE students discussed the findings of the medication reconciliations with their pharmacist preceptors, who updated the medication histories in the electronic medical record (EMR) and communicated with prescribers directly about identified medication-related problems. All medication reconciliation was documented using a standardized note template in the EMR. MAIN OUTCOME MEASURES: Number of medication discrepancies found, including medication additions, medication deletions, dose changes, and herbal product additions;  medication-related problems-including drug-drug interactions, untreated indications (e.g., @entity390 , @entity391 , @entity158 , need for prophylactic medications), failure of @entity1 to receive prescribed medications,  and  adverse drug reactions-were also documented. RESULTS: Medication reconciliation was completed for 510 @entity1 through the student pharmacist/pharmacist preceptor-led intervention during  a 1-year period between January 1, 2013, and December 31, 2013. A total of 88% of @entity1 had at least one discrepancy identified in their medication history and corrected in the EMR. In addition, 11.4% of @entity1 had a medication-related problem identified. CONCLUSIONS: Pharmacy-led medication reconciliation identified a large number of discrepancies among our hematology/oncology @entity1 . This intervention allowed for correction of discrepancies in the EMR leading to improved accuracy of @entity1 medication lists. In addition, it provided a valuable learning experience for student pharmacists.

Evaluation of outpatient medication reconciliation involving student pharmacists at a comprehensive XXXX center.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity390 :: ('MESH:D009325', 'Disease') :: ['nausea'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer', 'Cancer', 'Comprehensive Cancer Network (NCCN) cancer'] @entity391 :: ('MESH:D014839', 'Disease') :: ['vomiting'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain']
@entity5 :: (MESH:D009369,Disease) :: ['cancer']
