Aidan Bush, Patrick Blankenship, Crystal Laudermilk, Susan Roberts, Rob Lucas Prisma Health Blount Memorial Hospital – Maryville, TN
Background: According to the CDC, adverse drug reactions (ADRs) cause approximately 1.5 million emergency department (ED) visits annually in the United States and are often linked to recent medication changes. Medication reconciliation technicians (MRTs) profoundly impact the quality of patient care within the hospital by obtaining accurate medication histories. While their role in identifying adverse drug reactions is often implied, there is limited research directly demonstrating their impact on patient care through the early identification of ADRs. The purpose of this retrospective cohort study is to evaluate the impact on patient care by expanding the role of MRTs with the addition of a single, targeted question to their usual workflow.
Methods: This single‑center retrospective cohort study evaluated the impact of a workflow adjustment involving MRT‑assisted medication history collection at Prisma Health–Blount Memorial Hospital. The intervention cohort included all patients interviewed by an MRT between September 1–30, 2025. Patients reporting medication changes within the preceding 30 days were referred to a pharmacist for ADR assessment. The primary outcome was the incidence of ADRs identified through the updated MRT process. Secondary outcomes included characterization of ADR types and associated pharmacist interventions.
Results: During September 2025, the pharmacy team identified 17 ADRs, with 7 (41%) directly attributed to the updated MRT‑supported workflow. MRTs completed 1,163 interviews during this period, a slight decrease from 1,330 interviews in 2024, consistent with fewer hospital admissions (713 vs 757, respectively). Among 51 patients reporting a medication change within the previous 30 days, 7 (13.7%) were confirmed to have experienced a true ADR following a pharmacist review. Secondary outcomes showed that ADRs identified through MRT interviews most often involved drug–disease interactions (5, 71.4%), followed by dose‑related events (2, 28.6%). Pharmacists completed 9 interventions in response to identified ADRs, most frequently discontinuing the offending medication (7, 77%) and initiating alternative therapy when indicated.
Conclusions: Although adding the 30‑day medication‑change question did not substantially increase overall ADR interventions, the process meaningfully enhanced the MRT’s role in identifying medication‑related problems and highlighted opportunities to further expand MRT involvement in pharmacy‑led safety workflows.
