Background: Medication errors are common, with more than half of patients estimated to have greater than or equal to one unintended medication discrepancy at hospital admission.  Medication reconciliation can identify errors. Although there has been significant investigation into the most effective logistical strategies for performing medicine reconciliation within the healthcare system, there is little investigation [...]

Background: Medication discrepancies, defined as unexplained differences between documented medication regimens, are highly prevalent in the hospital setting and an important contributor to adverse drug events.  In the hospital setting, 27% of all prescribing errors occur as a result of inaccurate medication histories at the time of admission. Pharmacist-recorded medication histories have been shown to result [...]