Medication reconciliation is a validated patient-safety strategy aimed at minimizing medication-related adverse events. This study assessed the impact of educational interventions on the medication reconciliation practices of hospital pharmacists managing ambulatory patients with diabetes and hypertension. A non-randomised controlled clinical trial was conducted to evaluate medication reconciliation practices among pharmacists at two study sites. A total of 85 pharmacists at the intervention site and 61 pharmacists at the control site were included. To indirectly assess baseline medication reconciliation practices, the principal investigator performed medication reconciliation for 334 ambulatory patients with diabetes and/or hypertension (183 at the intervention site and 151 at the control site). Following baseline assessment, pharmacists at the intervention site received a general educational intervention. Subsequent medication reconciliation was performed by the principal investigator among two additional patient cohorts at three months (n=96; intervention 46, control 50) and six months (n=90; intervention 44, control 46) after the intervention to evaluate post-intervention practices. A focused educational intervention was later delivered to a subset of 15 pharmacists at the intervention site. After this targeted training, these pharmacists conducted medication reconciliation for another cohort of 140 patients. The completed medication reconciliation forms were independently reviewed by three clinical pharmacy experts. Data were analysed using descriptive statistics (frequencies, percentages, and mean ± standard deviation) and inferential tests, including Pearson’s correlation, independent-samples t-test, and one-way analysis of variance (ANOVA), with statistical significance defined as p<0.05.Medication reconciliation practices were suboptimal at baseline at both study sites. Following the general educational intervention, a significant reduction of 42.8% in medication discrepancies was observed at the intervention site (p<0.001). Additionally, six months after the intervention, there was a significant 54.3% increase in the proportion of patients who brought their medication packs to clinic visits, facilitating more accurate medication reconciliation (p=0.003). Drug therapy problems identified by intervention pharmacists increased over time, with 35, 66, and 48 problems detected at one, three, and six months post-intervention by 31 (43.1%), 33 (66.0%), and 32 (71.1%) pharmacists, respectively. Following the focused educational intervention, the 15 trained pharmacists identified and resolved 75 medication discrepancies (10.8%) out of 695 prescribed medications among 42 patients (30%).Both general and focused educational interventions significantly enhanced pharmacists’ medication reconciliation practices at the intervention site. These findings highlight the value of pharmacist education in improving medication safety and underscore the potential of such interventions to raise awareness and reduce medication-related harm in developing country settings.
