Improving Patient Safety Through Medication Reconciliation at Care Transitions: A Mixed Methods Systematic Review
In brief
Medication reconciliation cuts 30-day readmissions by 27% across 70 studies
Across 70 studies, medication reconciliation was associated with 27% fewer 30-day all-cause readmissions than usual care, while also reducing discrepancies, adverse drug events and emergency visits. Pharmacist-led programs and reconciliation at hospital admission stood out, but the review does not establish which combination of protocol components works best across care settings.
- Journal
- Journal of general internal medicine (Q1)
- Published
- 29 October 2026
- Study design
- Systematic review of cohort studies
- Evidence level
- Level 2, Moderate (CEBM 2a)
- Authors
- Da Feng, Zhe Jin, Jian Zou, Yuan Zhang, Xinxin Guo, Zehao Zheng, et al.
- PMID
- 42955207
- DOI
- 10.1007/s11606-026-10376-9
Why clinicians should know about it
- Picked for Internal Medicine (paper of the day, 30 October 2026): Medication reconciliation reduces discrepancies and readmissions
Abstract
BACKGROUND: Medication reconciliation (MedRec) is a cornerstone patient safety practice during care transitions. However, evidence regarding the specific implementation strategies that contribute to its effectiveness remains limited. This study sought to elucidate the essential ingredients of a Medication Reconciliation Standard Operating Protocol (MedRec SOP) and their impact on enhancing patient safety outcomes compared to usual care. METHODS: We conducted a mixed-methods systematic review following PRISMA guidelines. PubMed, Web of Science, and Embase were searched for studies (January 2000-May 2024) assessing MedRec interventions compared to usual care. Data on study design, MedRec SOP components, and patient safety outcomes were extracted. Random-effects meta-analyses were performed for quantitative synthesis. RESULTS: From 7209 screened records, 70 studies were included, describing 20 distinct MedRec SOP ingredients. Meta-analysis demonstrated that MedRec significantly reduced medication discrepancies (RR = 0.39, 95% CI 0.28-0.53), adverse drug events/reactions (RR = 0.61, 95% CI 0.47-0.79), 30-day all-cause readmissions (RR = 0.73, 95% CI 0.68-0.78), emergency department visits (RR = 0.60, 95% CI 0.52-0.68), and drug-related readmissions (RR = 0.51, 95% CI 0.31-0.84). Subgroup analyses identified pharmacist-led interventions and MedRec performed at hospital admission as particularly effective strategies. The SOP component "MedRec on admission" showed the highest effective ratio (ER = 9.40). CONCLUSIONS: Our systematic review supports the implementation of MedRec programs that include some components aimed at optimizing the MedRec intervention design. MedRec is a promising implementation strategy to improve patient safety and can be incorporated into the healthcare system. PROSPERO REGISTRATION NUMBER: CRD42024491225.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.