Medication reconciliation at admission cut readmissions by about a quarter across 70 studies

The edition in brief

A mixed-methods systematic review of 70 studies found medication reconciliation at care transitions lowered medication discrepancies (RR 0.39), adverse drug events (RR 0.61), 30-day readmissions (RR 0.73) and emergency visits (RR 0.60), with pharmacist-led reconciliation at admission most effective. A Singapore regression-discontinuity study of 24,803 surgical patients found mandatory internist referral for preoperative sodium below 130 mmol/L did not change 30-day mortality, ICU admission or length of stay, though one-year mortality may have been lower, especially in cardiac and kidney disease. A meta-analysis of 105 studies found malignancy associated with roughly doubled in-hospital and longer-term mortality in sepsis, most consistently with haematological cancers; estimates were unadjusted. A review of 21 studies found patient navigation, reminders and automated referral raised colonoscopy completion after an abnormal faecal test from about 48% to 69%. The pearl covers safe correction rates for chronic hyponatraemia.