Original Article

Medication Reconciliation and Drug–Drug Interactions: An Old Process with a New Approach

An old process with a new approach


Background: The occurrence of drug–drug interactions (DDIs) and insufficient attention to
medication reconciliation is one of the important challenges of pharmacotherapy in hospitalized
patients. The aim of this study was to determine the extent of drug–drug interactions in patients
based on medication reconciliation strategy.
Methods: This descriptive cross-sectional study was performed for six months in patients admitted
to Imam Reza Hospital in Amol, North of Iran. The data were obtained by using a medication
reconciliation tool through a random sampling of patients admitted in Hospital wards from May
2014 until October 2014. A total of 200 patients were enrolled in the study. All patients had a history
of medication use before admission. The drug interactions have been checked according to Drug
Interaction Facts between newly prescribed drug and medication patient using before admission.
The number and frequency of data were summarized by SPSS21 statistical software.
Results: Major and Moderate DDIs were found in 7.5% and 64% of prescriptions. The most frequent
DDIs were seen in those who were taking psychiatric drugs (33%) and cardiovascular drugs (30%).
Most DDIs occurred among women over 60 years of age. The most frequently occurring DDIs
was pharmacokinetics interaction between clopidogrel and atorvastatin (n=9). Other frequent
interactions were between ceftriaxone and heparin (n=8) and metoprolol and insulin (n=3).
Conclusion: This study showed a high rate of drug interactions and especially confirms the
importance of medication reconciliation in providing a comprehensive drug history and exploring
drug interactions.

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IssueVol 9, No 1 (Winter 2021) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/jpc.v9i1.6035
Drug Interactions; Medication reconciliation; Drug Therapy; Patient Safety

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How to Cite
Ala S, Tonkaboni S, Bazi A, Salehifar E. Medication Reconciliation and Drug–Drug Interactions: An Old Process with a New Approach. J Pharm Care. 2021;9(1):39-44.