THE GOLD STANDARD IN PATIENT SAFETY: A REVIEW OF PHARMACY-LED, TECHNICIAN-DRIVEN MEDICATION RECONCILIATION

Abstract

Medication discrepancies at transitions of care represent a critical and pervasive threat to patient safety, contributing significantly to preventable adverse drug events (ADEs). These errors, which occur when a patient’s medication regimen is unintentionally altered during admission, transfer, or discharge, can lead to patient harm, increased healthcare utilization, and substantial costs. This review critically evaluates the evidence supporting a collaborative, pharmacy-led, technician-driven model for medication reconciliation (MedRec) as a superior strategy to mitigate these risks. The model is predicated on a strategic division of labor: specially trained pharmacy technicians are responsible for the meticulous collection of the Best Possible Medication History (BPMH), while clinical pharmacists provide oversight, verify the history, and perform the clinical reconciliation and intervention. Key implementation components, including structured technician training, defined team roles, and seamless workflow integration within the Electronic Health Record (EHR), are explored as foundational elements for success. The literature consistently demonstrates that this model yields superior outcomes compared to traditional approaches, including a dramatic increase in the accuracy of medication histories, a significant reduction in medication errors, and a marked improvement in pharmacist operational efficiency. This review synthesizes the clinical, operational, and economic evidence, concluding that the pharmacy-led, technician-driven model is a best practice in modern patient safety, effectively leveraging the unique skills of the pharmacy team to protect patients from medication-related harm.