Several studies have shown that pharmacists can successfully
implement medication reconciliation, but many
hospitals may find this impossible because of the expense.
Whether pharmacists need to be involved in the
entire process of medication reconciliation for every patient
remains to be seen. It may be possible to design rec- onciliation processes dependent on physicians and nurses
in most cases, using pharmacists for patients at particularly
high risk or when medication regimens are most in
doubt. Similarly, other components of our intervention
(patient counseling, early follow-up) might be reserved
for patients at highest risk for ADEs (eg, older patients
taking multiple medications32,33).