Abstract: Objective To explore the feasibility and effectiveness of clinical pharmacists providing pharmaceutical care (PC) based on medication reconciliation (MR) in clinical therapy through clinical pharmacists participating in the treatment process of a patient with large hemispheric infarction (LHI). Methods The clinical pharmacists performed MR and checked prescription on patient, and then searched medication errors and provided advice on the medication therapy. In the end pharmacists discussed with the doctors to decide the medication regimens, conducted the whole-process pharmaceutical care for the hospitalized patient. Results Some preventable adverse drug events and medication errors were avoided, and the patient was discharged in good condition after systematic treatment. Conclusion Medication reconciliation-based pharmaceutical care can optimize medication regimens, ensure patients' medical safety, and achieve the accuracy and consistency of medication therapy.

Key words: medication reconciliation, pharmaceutical care, large hemispheric infarction