Medication Reconciliation at Care Transitions Cuts Readmissions and Drug Events, Review Finds

The mixed-methods review, published in the Journal of General Internal Medicine, pooled data from studies comparing structured medication reconciliation programs against usual care and found consistent reductions in medication discrepancies, adverse drug events, hospital readmissions, and emergency department visits.

Researchers searched PubMed, Web of Science, and Embase for studies published between January 2000 and May 2024, screening 7,209 records and ultimately including 70 studies. Following PRISMA guidelines, the team extracted information on study design, the components of each medication reconciliation standard operating protocol, and patient safety outcomes, then combined the quantitative results using random-effects meta-analyses. The review was registered with PROSPERO under number CRD42024491225.

The pooled results showed that medication reconciliation reduced medication discrepancies by roughly 61 percent, with a relative risk of 0.39 (95 percent confidence interval 0.28–0.53). Adverse drug events and reactions fell with a relative risk of 0.61 (95 percent CI 0.47–0.79). Thirty-day all-cause readmissions declined with a relative risk of 0.73 (95 percent CI 0.68–0.78), emergency department visits dropped with a relative risk of 0.60 (95 percent CI 0.52–0.68), and drug-related readmissions were reduced with a relative risk of 0.51 (95 percent CI 0.31–0.84).

Beyond the headline numbers, the review sought to identify which specific implementation strategies made these programs work. The included studies described 20 distinct ingredients of a medication reconciliation standard operating protocol. Subgroup analyses pointed to two particularly effective approaches: interventions led by pharmacists and reconciliation performed at the time of hospital admission. Among the individual protocol components, carrying out medication reconciliation on admission showed the highest effective ratio, at 9.40.

The authors caution that evidence on which specific implementation strategies contribute to effectiveness has historically been limited, which is why they designed the review to isolate the essential ingredients of a successful protocol. Their conclusion is that medication reconciliation is a promising implementation strategy for improving patient safety and can be incorporated into the healthcare system, provided programs include components aimed at optimizing the intervention design. As with any systematic review, the findings reflect the pooled evidence of the included studies, and the meta-analytic estimates carry the uncertainty ranges reported above.

Subject of Research: Medication reconciliation interventions at care transitions and their effects on patient safety outcomes

Article Title: Improving Patient Safety Through Medication Reconciliation at Care Transitions: A Mixed Methods Systematic Review

Article References: Feng, D., Jin, Z., Zou, J., Zhang, Y., Guo, X., Zheng, Z., Chen, S., Zhang, D., & Feng, Z. (2026). Improving Patient Safety Through Medication Reconciliation at Care Transitions: A Mixed Methods Systematic Review. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-026-10376-9

Image Credits: AI Generated

DOI: 10.1007/s11606-026-10376-9

Keywords: medication reconciliation, patient safety, care transitions, systematic review, meta-analysis, medication discrepancies, adverse drug events, hospital readmissions, pharmacist-led interventions, emergency department visits, Improving, Patient