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Recent Research on Medication Management

discrepancies and pADEs or ADEs from a best possible medication history obtained from the electronic medical record (EMR) and the hospital medication list. Drug-related problems were identified and resolved by contacting the primary care physician. Education interventions included several elements: clarifying medication regimens; reviewing indications, directions, and potential side effects of medications; screening for barriers to adherence and early side effects; and providing patient counseling and physician consultation on optimizing medication regimens when appropriate. The average time the pharmacist spent preparing, conducting and coordinating a treatment plan, and documenting the medication reconciliation encounter was 70 minutes.