RESEARCH ARTICLE: Medication reconciliation knowledge among hospital pharmacists in Nigeria: A non-randomised controlled trial




Knowledge assessment, Medication, Non-randomised controlled trial, Pharmacist, Reconciliation


Background: Medication reconciliation (MR) is a patient-centred evolving role of pharmacists that improves patient’s health outcomes. 

Aim: To assess the effect of an educational intervention on pharmacists’ MR knowledge in two Nigerian tertiary hospitals. 

Methods: A two-arm parallel non-randomised controlled trial was carried out at two tertiary hospitals in Nigeria, one as intervention and the other as control site. Pharmacists’ MR knowledge was assessed pre-intervention and at one-, three- and six-month post-intervention. The intervention consisted of seminar and role-plays. Data were summarised with descriptive and inferential statistics. 

Results: A total of 75 pharmacists completed the study. Scores for pre-intervention out of a total of 38 was 19.31±4.76 in the intervention group and 17.50±6.86 in the control group. Post-intervention assessment scores (University College Hospital vs University of Ilorin Teaching Hospital) at one, three and six months were 29.82±5.01 vs 25.97±5.31, 31.53±4.99 vs 26.10±5.20, and 31.69±4.10 vs 23.07±3.98, respectively (p < 0.01). 

Conclusion: The educational intervention led to improved pharmacists’ MR knowledge.

Author Biographies

Akinniyi A. Aje , University of Ibadan, Nigeria

Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy

Segun J. Showande, University of Ibadan, Nigeria

Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy

Titilayo O. Fakeye, University of Ibadan, Nigeria

Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy


Al-Hashar, A., Al-Zakwani, I., Eriksson, T., & Al Za’abi, M. (2017). Whose responsibility is medication reconciliation: Physicians, pharmacists or nurses? A survey in an academic tertiary care hospital. Saudi Pharmaceutical Journal.

American Society of Health-System Pharmacists. (2013). ASHP statement on the pharmacist’s role in medication reconciliation. American Journal of Health System Pharmacy, 70(5), 453–456

Barnsteiner, J.H. (2008). Medication reconciliation. In: R.G. Hughes (Ed), Patient safety and quality: An evidence-based handbook for nurses. Rockville (pp. 459-472). M.D. Agency for Healthcare Research and Quality

Bond, C.A., & Raehl, C.L. (2007). Clinical pharmacy services, Pharmacy staffing, and hospital mortality rates. Pharmacotherapy, 27, 481–493

Buckley, M.S., Harinstein, L.M., Clark, K.B., Smithburger, P.L., Eckhardt, D.J., Alexander, E., Devabhakthuni, S., Westley, C. A., David, B., Kane-Gill, S.L. (2013). Impact of a clinical pharmacy admission medication reconciliation programme on medication errors in “high-risk” patients. Annals of Pharmacotherapy, 4712, 1599-1610

Cipolle, R.J., Strand, L.M., Morley, P. (2012). Pharmaceutical Care Practice: The Patient-Centred Approach to Medication Management. 3rd Edition, McGraw-Hill, Health Professions Division, New York

Coffey, M., Cornish, P., Koonthanam, T., Etchells, E., & Matlow, A. (2009). Implementation of admission medication reconciliation at two academic health sciences centres: Challenges and Success Factors. Healthcare Quarterly, 12, 102–109

Cornish, P.L., Knowles, S.R., Marchesano, R., Tam, V., Shadowitz, S., Juurlink, D.N., & Etchells, E.E. (2005). Unintended medication discrepancies at the time of hospital admission. Archives of Internal Medicine, 165(4), 424-9.

Drennan, J. (2010). Critical thinking as an outcome of a Master’s degree in Nursing programme. Journal of Advanced Nursing, 66(2), 422–431.

Farha, R.A., Hammour, K.A., Rizik, M., Aljanabi, R., & Alsakran, L. (2018). Effect of educational intervention on healthcare providers knowledge and perception towards pharmacovigilance: A tertiary teaching hospital experience. Saudi Pharmaceutical Journal, 26(5), 611-616

Feldman, L.S., Costa, L.L., Feroli, E.R., Nelson, T., Poe, S.S., Frick, K.D., Efird, L.E., Miller, R.G. (2012). Nurse-Pharmacist collaboration on medication reconciliation prevents potential harm. Journal of Hospital Medicine, 7(5), 396–401

Gleason, K.M., Brake, H., Agramonte, V., Perfetti, C. (2012). Medications at Transitions and Clinical Handoffs (MATCH) toolkit for medication reconciliation

Graabaek, T., Kjeldsen, L.J. (2013). Medication reviews by clinical pharmacists at hospitals lead to improved patient outcomes: a systematic review. Basic & Clinical Pharmacology & Toxicology, 112(6), 359-373

Guiffrida, D. (2015). A constructive approach to counseling and psychotherapy supervision. Journal of Constructivist Psychology, 28(1), 40-52,

Hatch, J., Becker, T., Fish, J. (2011). Difference between pharmacist-obtained and physician-obtained medication histories in the intensive care unit. Hospital Pharmacy, 46(4), 262-268

How-to guide: prevent adverse drug events by implementing medication reconciliation. (2011). Cambridge, MA: Institute for Healthcare Improvement. Available at :

Johnston, R., Saulnier, L., Gould, O. (2010). Best possible medication history in the emergency department: comparing pharmacy technicians and pharmacists. Canadian Journal of Hospital Pharmacists, 63(5), 359–365

Kane-Gill, S.L., Kowiatek, J.G., Weber, R.J. (2010). A comparison of voluntary reported medication errors in intensive care and general care units. Quality and Safety Health Care, 19, 55-59.

Kantchelov, A. (2008). Motivational interventions for methadone-treated patients. Heroin Addict Related Clinical Problems, 10(2), 11-20

Kwan, J.L., Lo, L., Sampson, M., Shojania, K.G. (2013). Medication reconciliation during transitions of care as a patient safety strategy: a systematic review. Annals of Internal Medicine, 158(5), 397–403

Kwan, Y., Fernandes, O.A., Nagge, J.J., Wong, G.G., Huh, J.H., Hurn, D.A., Pond, G.R., Bajcar, J.M. (2007). Pharmacist medication assessments in a surgical preadmission clinic. Archives of Internal Medicine, 167, 1034-1040.

MacPherson, H., Richmond, S., Bland, M., Brealey, S., Gabe, R., Hopton, A., Keding, A., Lansdown, H., Perren, S., Sculpher, M., Spackman, E., Torgerson, D., Watt, D. (2013). Acupuncture and counselling for depression in primary care: a randomised controlled trial.

Mahramus, T., Penoyer, D.A., Frewin, S., Chamberlain, L., Wilson, D., Mary Sole, M.L. (2014). Assessment of an educational intervention on nurses' knowledge and retention of heart failure self-care principles and the Teach Back method. Heart & Lung, 43(3), 204-212

Masotti, P., McColl, M.A. & Green, M. (2010). Adverse events experienced by homecare patients: a scoping review of the literature. International Journal of Quality Health Care, 22, 115-125

Mekonnen, A.B., Alhawassi, T.M., McLachlan, A.J., & Brien, J.E. (2018). Adverse drug events and medication errors in African hospitals: a systematic review. Drugs-Real World Outcomes, 5(1), 1–24

Mekonnen, A.B., McLachlan, A.J., & Brien, J.A. (2016). Pharmacy-led medication reconciliation programmes at hospital transitions: a systematic review and meta-analysis. Journal of Clinical Pharmacy and Therapeutics, 41(2), 128–144

Mekonnen, A.B., McLachlan, A.J., Brien, J.A. (2016). Effectiveness of pharmacist-led medication reconciliation programmes on clinical outcomes at hospital transitions: a systematic review and meta-analysis. British Medical Journal Open, 23(6).

Naicker, P., Schellack, N., Godman, B., & Bronkhorst, E. (2018). Creating and evaluating an opportunity for medication reconciliation in the adult population of South Africa to improve patient care, Hospital Practice, 46(3), 110-120.

National Institute for Health and Clinical Excellence (NICE). (2012). Patient experience in adult NHS services: improving the experience of care for people using adult NHS services. NICE clinical guideline 138. London: Royal College of Physicians. Available at:

Osakwe, A., Oreagba, I., Adewunmi, A.J., Adekoya, A., & Fajolu, I. (2013). Impact of training on Nigerian healthcare professionals' knowledge and practice of pharmacovigilance. International Journal of Risk & Safety in Medicine, 25, 219-227

Petrov, K., Varadarajan, R., Healy, M., Dravish, E., Cowden, C. (2018). Improving medication history at admission utilising pharmacy students and technicians: a pharmacy-driven improvement initiative. P&T : A peer-reviewed journal for formulary management, 43(11), 676–684

Rajesh, R., Vidyasagar, S., & Varma, D.M. (2011). An educational intervention to assess knowledge attitude practice of pharmacovigilance among healthcare professionals in an Indian tertiary care teaching hospital. International Journal of Pharmacy and Technology Research, 3, 678-692

Rozich, J.D., Resar, R.K. (2001). Medication safety: one organisation’s approach to the challenge. Journal of Clinical Outcomes Management, 8, 27-34

Subrayen, D., Naicker, P., Schellack, N. (2016). Medication reconciliation is an essential role for the pharmacist. South African Journal of Pharmacy, 83(1), 17-21

Sudulaguntla, A., Baby, E., Philip, F.M., John, L.M. (2018). A review article on effective patient counselling, Research and Reviews: A Journal of Pharmaceutical Science, 9(1), 12-17

Tam, V.C., Knowles, S.R., Cornish, P.L., Fine, N., Marchesano R., Etchells, E.E. (2005). Frequency, Type and Clinical importance of medication history errors at admission to hospital: A Systematic Review. Canadian Medical Association Journal, 17(5), 510–515

van Sluisveld, N., Zegers, M., Natsch, S., Wollersheim, H. (2012). Medication reconciliation at hospital admission and discharge: insufficient knowledge, unclear task reallocation and lack of collaboration as major barriers to medication safety. BioMed Central Health Service Research, 21(12), 170.

Wong, J.D., Bajcar, J.M., Wong, G.G., Alibhai, S.M., Huh, J.H., Cesta, A., Pond, G.R., & Fernandes, O.A.. (2008). Medication reconciliation at hospital discharge: evaluating discrepancies. Annals of Pharmacotherapy, 42, 1373–1379

World Health Organization. (2016). Medication Errors: Technical series on safer primary care. Available at:




How to Cite

Aje , A. A. ., Showande, S. J. ., & Fakeye, T. O. . (2021). RESEARCH ARTICLE: Medication reconciliation knowledge among hospital pharmacists in Nigeria: A non-randomised controlled trial . Pharmacy Education, 21, p. 528–537.



Research Article