The Canadian Patient Safety Institute defines medication reconciliation as “a formal process in which healthcare providers work together with patients, families, and care providers to ensure that accurate, comprehensive medication information is communicated consistently across transitions of care”. Following the medication reconciliation process is known to result in fewer adverse drug events and, therefore, positive health outcomes for patients. In 2010, Accreditation Canada, a nonprofit organization dedicated to health care improvement, mandated Canadian hospitals to have an established medication reconciliation program in at least one clinical area in order to become accredited. Certainly, Canadian hospitals face a number of challenges in meeting this accreditation standard, including the need for adequate staff and resource allocation. However, geographic, jurisdictional, and cultural differences contribute added complexity for patients coming from and being discharged to First Nations reserves, because registered First Nations persons and recognized Inuit are medically insured by the federal government, rather than by the provincial governments, which cover all nonregistered First Nations and non-Inuit persons. Caught between the federal and provincial health systems and accessing care in both municipalities (under provincial jurisdiction) and reserves (under federal jurisdiction), First Nations and Inuit individuals are subject to drastic service and funding inequities, which have direct impacts on all of the social determinants of health and health care services. The Calls to Action of the Truth and Reconciliation Commission of Canada stress the importance of closing the gaps in health outcomes between Indigenous (First Nations, Métis, and Inuit) and non-Indigenous people in Canada. Pharmacists, the most accessible of health care professionals and often ranked as the most trusted, are uniquely and ideally situated in Canada’s health care system to both respond to and proactively prevent inequities in the health outcomes experienced by Indigenous people in Canada. In particular, discharge medication reconciliation performed by hospital pharmacists is likely to contribute to positive health outcomes for all hospitalized patients, including First Nations individuals being discharged to a reserve.
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