This prospective, nonrandomized study was approved by the University of Saskatchewan Behavioural Research Ethics Board.
Residents of Saskatchewan with a Saskatchewan health card who were at least 18 years of age and who were admitted between December 1, 2006, and March 31, 2007, as general medicine patients to either of 2 clinical teaching units (within the same ward) in the Saskatoon Health Region were eligible to participate in the study. Patients were excluded if they were unable to speak or understand English, had an obvious cognitive impairment, were unconscious or critically ill, or had been transferred from a hospital or long-term care facility in which they or their primary caregiver was not in charge of administering their medications.To identify potential participants, the pharmacist printed a computer-generated list of new admissions each day. For each patient on the list, the medical chart was reviewed to screen for eligibility. If eligible, patient consent was requested; for patients who granted consent, the pharmacist then accessed the PIP profile to generate a list of the medications that had been dispensed in the previous 4 months. The following information appeared on the printed PIP profile: drug name, strength of the medication dispensed, dispensing date, quantity dispensed, duration of supply (number of days), name and phone number of the pharmacy that dispensed the medication, and name of the prescribing physician. A medication was considered inactive if the most recently dispensed supply counted down to zero before the date of hospital admission. The total daily dose for each medication was determined by dividing the total quantity of medication dispensed by the number of days’ supply. These rules applied for both as-needed and regularly scheduled medications, as there is no way to identify as-needed medications from the PIP profile. A 4-month PIP profile was chosen to ensure that medications dispensed as a 100-day supply would appear on the profile. After reviewing the patient’s PIP profile, the pharmacist prepared a BPMH with the patient and/or caregiver. For each medication that the patient stated he or she was taking, the pharmacist document­ed the dose, frequency, indication for use, and duration of therapy. Information on compliance and side effects was also obtained. When necessary, the pharmacist contacted the patient’s community pharmacies, physicians, or other hospitals for clarification of the patient’s home medications. If any discrepancies were identified in which a medication that the patient reported taking was not listed on the patient’s 4-month PIP profile, the pharmacist then reviewed and printed a 12-month PIP profile.
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The 12-month profile was assumed to catch multiple prior fills of a medication (i.e., stockpiling), any medications with which the patient might not be compliant, and as-needed medications not dispensed in the previous 4 months but still being taken by the patient. The 12-month PIP profile was printed and reviewed only when needed, as it is the 4-month profile that the Saskatoon Health Region is considering downloading to a medication reconciliation form, and we therefore wanted to determine its accuracy for determining patients’ medication use before admission. Information obtained from the BPMH was documented on the standard­ized data collection form. Any discrepancies identified between a patient’s PIP profile and the BPMH were described and coded.

Discrepancies with the potential to affect the patient’s care and safety were resolved by the investigator (J.T.). The time required to access and print the patient’s PIP profile, review the medical chart, and obtain the BPMH was documented. Viagra Professional

Statistical analysis was performed using SPSS version 15. Statistical significance was defined as p < 0.05, as determined by a paired t test.