Background Medicines reconciliation in the emergency department (ED) is essential to optimising the safe and effective use of medicines.
Purpose To analyse reconciliation errors avoided by the ED pharmacist and to assess the severity and clinical relevance.
Material and methods The study was conducted between November 2013 and June 2014 in a general hospital of 330 beds. A pharmacist attended the daily ED meeting, selecting patients at higher risk of medicines error. The pharmacist wrote the home medicines history using primary care electronic records and interviews with the patient/caregiver, and compared it with the prescription in the ED. Medicines reconciliation was carried out with the emergency physician. Any unjustified discrepancy was considered a reconciliation error (RE). REs were classified according to the Consensus Statement of the Spanish Society of Hospital Pharmacy (SEFH). The severity of REs were estimated using the categorization of The National Coordinating Council for Medicines Error Reporting and Prevention, considering pharmacist intervention clinically relevant if it avoided potential patient harm.
Results 132 patients were included. 51% were female and the mean age was 75.8 ± 9.4 years. The average number of drugs per patient was 11.4 ± 4.2. 239 REs were found affecting 89 patients (67.4%), the average error per patient was 1.8 ± 2. Types of RE were omission (71.1%), different route, dose or regimen (14.6%), incomplete prescription (8.8%), different drug (3.8%), and interaction (1.7%). The severity of the RE was: 14.2% reached the patient without causing harm (C), 35.2% reached the patient and required intervention/monitoring (D), 33.9% would have caused temporary harm (E) and 16.7% harm that would have prolonged hospitalisation (F). 85.9% of interventions on clinically relevant REs (category E–F) were accepted, thus avoiding potential harm to 61.8% of patients with reconciliation errors.
Conclusion The high proportion of patients in which the ED pharmacist intervention prevented a potential harm highlights the importance of his role in the reconciliation process.
References and/or Acknowledgements Thanks to the Emergency Department.
No conflict of interest.
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