Gholamreza Reza Poorheidari
Mahdi Mashhadi Akbar Boojar

During the move between healthcare settings and changes in the medical status of patients, it is very important to update the correct drug regimen according to the clinical conditions to avoid the possibility of medical errors. Nearly half of medication errors occur during initial admission, transfer between hospital departments, and before discharge. Among these errors, about ۳۰% of cases have the potential of seriously harming the patient. Some risk factors, such as old age and the number of drugs used, are associated with an increased risk of medication discrepancies. The medication reconciliation process can significantly reduce the risk of potential errors. It includes obtaining, verifying, and documenting a list of the patient's current medications and comparing it to the patient's medication orders and condition to identify and resolve any discrepancies. Comparing what is being prescribed in one setting with what is being taken in another will prevent errors of drug-drug interactions, omission, and other discrepancies. Pharmaceutical reconciliation is an important element of patient safety and rational drug use, and it can significantly contribute to the health economy

Discharge Medication, hospitals, Medication Errors, Pharmaceutical Reconciliation