Medication reconciliation in the elderly: a literature review

INTRODUCTION: Aging people represent a growing population in Brazil and worldwide. Physiological changes due to age, comorbidities, and polypharmacy make them highly susceptible to adverse drug events. Medication reconciliation may be a useful strategy to reduce these events, when the patient is transferred between different levels of health care. OBJECTIVE: To conduct a review of the literature on medication reconciliation in elderly people in the transition of health care. METHODOLOGY: It was done an overview of the literature available in PubMed. INCLUSION CRITERIA WERE: population involving exclusively elderly or mostly elderly; language in English, Spanish or Portuguese; articles published in the last five years. Two reviewers examined the titles and abstracts, and proceeded in a completed reading of each article and the inclusion of the most relevant ones. RESULTS: Twelve studies were included. Half described the rate and types of discrepancies in the transition points; highlighting the drug omission as the main discrepancy. Three assessed the contribution of pharmacists in the process, indicating the higher quality obtained with their involvement. Five analyzed the consistency of the information provided in the continuity of care and the impact of medication reconciliation on medication errors, demonstrating the importance of collecting an initial precise medication history to reduce adverse events, polypharmacy and medication errors. CONCLUSION: Medication reconciliation may be an important tool for the safety of elderly patients in the transition of health care. The role of the pharmacist and the integrity of the medication history were related to the improvement of the process and patient care.