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An 80-Year-Old Woman with Multiple Medical Problems Is Admitted to the Hospital

Question 1291

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An 80-year-old woman with multiple medical problems is admitted to the hospital for evaluation of syncope.  Her heart rate is found to be 36/min.  She was admitted to another hospital recently, then discharged to an acute rehabilitation facility, and then sent to a nursing home.  Review of her history shows that the patient is taking high-dose diltiazem, metoprolol, and atenolol.  Which of the following medication reconciliation interventions is most likely to result in a decrease in adverse drug events and health care utilization?


A) Educational booklets distributed to patients
B) Educational booklets distributed to physicians
C) Information technology-related interventions
D) Nurse and nurse assistant-directed interventions
E) Pharmacist-directed interventions

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