Feasibility and Determinants of Medication Reconciliation at Hospital Admission in a Resource-Limited Setting: Evidence from Burkina Faso

Background: Medication errors during transitions of care are a major patient safety concern, particularly in low- and middle-income countries where medication reconciliation remains poorly implemented. This study assessed the feasibility of pharmacist-led medication reconciliation at hospital admission in Burkina Faso and characterized medication discrepancies and associated factors. Methods: A six-week prospective implementation study was conducted from May to June 2018 among 52 consecutively admitted patients in the medical department of Tengandogo University Teaching Hospital. A trained clinical pharmacist performed medication reconciliation after admission, prescribing, following the WHO High 5s standards. Feasibility was assessed through completion, timeliness, and workload. Discrepancies and associated factors were analyzed using appropriate bivariate tests and an exploratory multivariable logistic regression limited to two prespecified predictors because of the small number of outcome events. Results: Complete medication reconciliation was achieved in 46/52 patients (88.5%). Mean active pharmacist time was 4.0 hours ± 1.8 hours per patient, while reconciliation was completed within 24 hours in 31/46 patients (67.4%). Overall, 109 discrepancies were identified in 35 patients (76.1%), corresponding to a mean of 2.4 discrepancies per patient. Twenty-three discrepancies (21.1%) were unintentional medication errors, affecting 14 patients (30.4%); omissions accounted for 69.6% of errors. Patients aged ≥ 65 years showed a non-significant trend toward more discrepancies (90.0% vs. 65.4%; p = 0.08). Polypharmacy (≥5 medications) showed the strongest bivariate association with medication errors: all patients with errors had polypharmacy (p = 0.08). Because of perfect separation, polypharmacy was not included in the multivariable model. Neither age nor chronic disease was significantly associated with medication errors after adjustment. Corrective action was documented in 7/14 affected patients (50.0%). Only 1/49 healthcare staff members (2.0%) reported familiarity with medication reconciliation. Conclusion: Pharmacist-led medication reconciliation appears feasible in a resource-constrained African hospital and identifies a substantial burden of medication discrepancies. Polypharmacy may be a useful criterion for targeted screening, although larger studies are needed to confirm this association. Scaling up medication reconciliation should include staff training and integration of pharmacists into hospital care.