Effect of Pharmacy Student Peer Supervision on the Accuracy of Admission Medication Reconciliation: Prospective Pre-Post Observational Study

Background: Although medication reconciliation is known to reduce the frequency of medication errors, its practical implementation can be challenging in several respects. In our institution, pharmacy students perform medication reconciliations at admission under the supervision of a pharmacist or pharmacy resident. Objective: The objective of the study was to evaluate the impact of peer supervision (ie, the supervision by a pharmacy student of a medication reconciliation performed by another pharmacy student) on the accuracy and efficiency of admission medication reconciliations. Methods: A prospective, single-center, observational study was conducted in 2 clinical departments at Lille University Medical Center (Lille, France). Initially, organizational procedures were defined and a checklist for reconciliation supervision was developed. A baseline (reference) period without peer supervision was compared with an implementation period with peer supervision. Results: A total of 317 medication reconciliations were conducted: 102 (32.2%) without supervision and 215 (67.8%) with supervision by a pharmacy student. Peer supervision reduced the pharmacist time required for this task by 52%; the mean time decreased from 23 (SD 11) minutes to 11 (SD 6) minutes. Furthermore, peer supervision was associated with a decrease in the number of errors made by students (from 1.5 to 0.9 per reconciliation) and detected by pharmacists during reconciliation validation. Conclusions: Student peer validation appears to be an innovative, strategic method for optimizing medication reconciliations, freeing up pharmacist time, and leveraging the skills of pharmacy students.