Implementing the medicines reconciliation tool in practice:challenges and opportunities for pharmacists in Kuwait

Background: Using the medicines reconciliation tool which involves preparing an updated list of patient's medications at each transition of care can significantly enhance patient safety. The pharmacist has been leading this process in western healthcare systems. Little is known about pharmacists' role in medicines reconciliation in Middle Eastern Countries.Objectives: To explore the implementation of medicines reconciliation in Kuwait hospitals, pharmacists' role in this process and perceptions of the challenges in implementing it in practice.Methods: This was an exploratory descriptive study of medicines reconciliation practices at eleven secondary/tertiary hospitals in Kuwait. A mixed-methods research design was used whereby 110 hospital pharmacists participated in 11 focus groups and 88 of them completed self-administered surveys.Results: Participants reported that medicines reconciliation is poorly applied in hospitals and that they had limited role in the process. The current medicines reconciliation policy does not assign any responsibilities for pharmacists in this process. The most significant barriers to applying medicines reconciliation by pharmacists were inadequate staff numbers, lack of time, difficult access to patient information, lack of policy to support pharmacist role and patients' poor knowledge about their medications.Conclusions: Hospital pharmacists in Kuwait advocate implementing medicines reconciliation but report significant strategic/operational barriers to its application. Efforts are needed in policy reform and team training to enable pharmacists provide effective patient care services including medicines reconciliation.