Medication reconciliation and seamless care in the long-term care setting

The evidence in support of medication reconciliation has increased rapidly in recent years, while the need for an improved medication-use system in the LTC setting remains. This article describes the essential elements of medication reconciliation and its application to the LTC setting. First, a case presentation depicts some of the typical clinical problems involving medications that face residents and clinicians in this setting and during transitions of care. Second, a brief literature review of medication reconciliation follows, with a special emphasis on the LTC setting. Third, a practical real-life example of adopting this service in several facilities in one state, the Nursing Home Medication Safety Project in Massachusetts, is reviewed. Finally, suggested strategies for implementation are presented, including implications for clinicians.