Background Medication reconciliation is done to identify and correct medications errors but needs significant resources.
Purpose The aim of this study was to create a durable medication reconciliation activity that covers patients who are at the greatest risk of medication errors throughout the medical facility.
Material and methods In this prospective single centre study over 2 months patients who were hospitalised through the emergency room of our facility were included. The emergency department prescribers filled out a selection grid to identify priority medication reconciliations based on following clinical and therapeutic risk factors:
number of known drugs;
anticoagulant, cardiovascular, antidiabetic, anticancer drugs, eye drops and anticonvulsants; and
history of hypertension, heart failure, diabetes, cancer, epilepsy, tobacco consumption and memory disorders.
This pre-established grid was based on a bibliographic search1 and a study performed in our hospital. A pharmacist determined each patient’s score daily. If the patient was still hospitalised 48 h after recovering the grid, a score ≥10 resulted in reconciliation.
Results 82 patients were included. A score ≥10 was found in 23 patients (28%). 16 medication reconciliations lasting 45 min were performed (19%). 7 patients did not participate in medication reconciliation despite a score ≥10 because it was beyond the time limit. Each prescription at admission included a mean of 1.1 unintentional deviations (UID).
Reconciliation in a random unit was as time consuming as in other studies (30 ± 15 min2) but time was on the high side. The number of UID/admission was similar to that in other studies2 (1.2). The main limitation of this study was insufficient collection of risk factors by emergency prescribers.
Conclusion This grid, based on risk factors, made the selection possible. This process could be optimised by using a computerised grid in the patient’s medical file. Involving other professionals in data collection is another option.
References and/or Acknowledgements
Groupe de travail sur le bilan comparatif des médicaments de l’APES. Réalisation du BCM dans les ES québécois (web). Available from: http://www.cha.quebec.qc.ca/fileadmin/cha/internet/specialites_medicales/pharmacie/fichiers/guide_apes_bcm.pdf
Dufay E, et al. La conciliation des traitements médicamenteux (web). OMEDIT presented at: Le parcours de soins; 2013; CH Luneville. Available from: http://www.omedit-basse-normandie.fr/gallery_files/site/1533/1534/1571/2192/2825/5534.pdf
References and/or AcknowledgementsNo conflict of interest.
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