Use of a medication reconciliation tool in an outpatient geriatric clinic

Objective To determine whether use of the Medication Reconciliation Review of Systems Subject (MR ROSS) tool is an effective method to identify errors of omission at an initial visit in an outpatient geriatric clinic. Design: Retrospective chart review. Setting Alexian Brothers Community Services (ABCS) Program of All-inclusive Care for the Elderly (PACE), St Louis, MO, from January to December 2012. Patients: 40 patients newly enrolled in ABCS PACE. Intervention: After the medication evaluation was completed, MR ROSS was used to collect additional medication information to identify errors of omission. Using MR ROSS, the clinical pharmacist asked the patient, "Are you taking anything for [system]?" This line of questioning was continued for every noted area. Main outcomes measure Number of patients having an error of omission detected using MR ROSS. Results: Of the 40 patients, 31 (77.5%) had one or more errors of omission identified by MR ROSS. Of these patients, an average of 4.0 additional medications per patient was identified. Patients with a Mini-Mental State Examination score of 24 or greater were more likely to have an error of omission detected using MR ROSS (P = 0.009). Of the 123 additional medications identified using MR ROSS, 73.2% and 69.9% were nonprescription and as-needed medications, respectively. Of the medications found using MR ROSS, 57%, 17%, and 8.6% were oral medications, topical medications, and oral inhalers, respectively. Conclusion: Use of the MR ROSS tool was a feasible and effective method to identify errors of omission at an initial visit in an outpatient geriatric clinic.