치료전환기 약물 조정 프로세스의 운영현황과 시사점: 호주, 영국, 미국을 중심으로

Medication Reconciliation during Transition of Care: Lesson From Australia, the United Kingdom, and the United States

With the aging population, there is a growing concern about drug-related problems (DRPs) arising from polypharmacy. DRPs tend to increase, especially during transitions of care (TOC). Therefore, the World Health Organization (WHO) recommends the use of Medication Reconciliation (MR) to address DRPs during TOC. This study aims to examine the effectiveness of MR and the operational status in the United Kingdom, the United States, and Australia to obtain implications. The definitions and effectiveness of MR are investigated through literature review and the website of each country's health institution was referred to understand detailed policies. In the United Kingdom, based on the NICE guidelines, all newly hospitalized patients are required to undergo MR by multidisciplinary team (MDT) within 24 hours of hospitalization. In the United States, The Joint Commission has included medication reconciliation for patients at all points of care transition as a requirement for hospital accreditation. In Australia, MR is a formal process of obtaining, verifying and documenting an accurate list of a patient's current medications on admission. All of these countries adopt the MDT approach in conducting MR. In particular, pharmacists play a crucial role in ensuring the effective execution of MR throughout particularly by conducting MR upon admission and performing final reviews of the Immediate Discharge Letter (IDL) upon patient discharge. Among various MR programs, pharmacist-led MR have shown the greatest clinical and economic benefits. Therefore, active participation of pharmacists within the MDT is emphasized. Given that MR has been shown to reduce DRPs and healthcare costs during TOC, it is necessary to institutionalize MR as part of the medication management program for elderly hospitalized patients.