Medication review and reconciliation in older adults

Key summary pointsAim This review article describes medication reconciliation and medication review processes, their effectiveness among older people, and the implementation issues in daily practice. Findings Medication reconciliation and medication review are two distinct but complementary clinical processes that may be efficient to decrease drug-related problems and prevent adverse drug events. Effectiveness and successful implementation of medication reconciliation and medication review require cautious acknowledgement of human factors and organizational issues and alignment of treatment recommendations with patient preferences and goals Message The involvement of geriatricians remains essential for the successful implementation of medication reconciliation and medication review in geriatric settings and thus better drug risk management for older patients. Older people are frequently exposed to polypharmacy, inappropriate prescribing, and adverse drug events. Two clinical processes can help geriatricians to optimize and increase the safety of drug prescriptions for older adults: medication reconciliation and medication review. Medication reconciliation provides the best possible medication history and identifies and resolves discrepancies in drug prescriptions. During the medication review, the best possible medication history is crosschecked against other data, including morbidities, patient's preferences, or geriatric syndromes, to produce a personalized medication strategy. Alignment of treatment recommendations with patient preferences and goals through shared decision-making is particularly important in medication review. Medication reconciliation and medication review have proven to be effective, but their broad implementation remains difficult. Indeed, these procedures are time-consuming and require specific skills, coordination between different healthcare professionals, organizations and dedicated means. The involvement of geriatricians therefore remains essential for the successful implementation of medication reconciliation and medication review in geriatric settings and among frail older people.

Automated summary

Medication reconciliation and medication review are essential tools for optimizing drug prescriptions for older adults by geriatricians, requiring careful consideration of human factors and organizational issues, and alignment with patient preferences and goals.