Background Since June 2016, medication reconciliation (MR) has started in an observational unit of our emergency department (ED) where patients are waiting before their transfer to permanent care units. Patient’s best possible medication history (BPHM) is collected by a pharmacy intern who transmits it to the referent pharmacist of the transferred care unit. Then, the referent pharmacist compares BPHM with the admission prescription produced by the specialist in this unit and detects unintentional discrepancies (UD). If a UN is found, he alerts the prescriber and tracks the pharmaceutical intervention (PI). 8 pharmacists are involved in this organisation: 1 pharmacy intern in ED and 7 referents of care units.
Purpose The objectives were to assess the benefits of this new organisation on the safety and quality of drug management at admission and during hospitalisation.
Material and methods From June 2016 to September 2016, all patients with a BPHM collected during their stay in the ED were included. The following data were collected and analysed with Excel: time for collecting BPHM and comparing it with admission prescriptions; number and types of UD; and number and acceptance rate of PI.
Results 75 patients were reconciliated. Median times were: 20 min to obtain BPHM in the ED and 10 min for the referent pharmacist to finalise MR. 30 UD were identified, including 19 (63%) drug omissions and 11 (37%) incorrect frequencies or incorrect dosages. Mean number of UD per patient was 0.4 (30/75) and 27% (20/75) of patients had at least 1 UD in their prescriptions. 30 PI were found and 93% (28/30) were accepted by prescribers.
Conclusion Although patients’ BPHM were collected at admission in the ED and traced in their files, referent pharmacists found UD in admission prescriptions after transfer to care units. Thanks to this organisation, medications errors were avoided and acceptance rate of PI was important. Sharing of MR steps allowed referent pharmacists to take time for these clinical pharmacy activities. MR, already well accepted and considered a support by emergency physicians, is ongoing. It will be necessary to assess the relevance of this new organisation by measuring the clinical impact of PI.
No conflict of interest
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