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The clinical impact of medication reconciliation on admission to a French hospital: a prospective observational study
  1. Edith Dufay1,
  2. Sophie Morice2,
  3. Alexandre Dony1,
  4. Thomas Baum3,
  5. Sébastien Doerper1,
  6. Alain Rauss4,
  7. David Piney1
  1. 1Pôle de Logistique Médicale, Service de pharmacie, Centre Hospitalier de Lunéville, Lunéville, France
  2. 2Service de pharmacie, Centre Hospitalier Universitaire de Nancy, Nancy, France
  3. 3Pôle de Logistique Médicale, Service de la gestion des risques, de l’évaluation et de la qualité, Centre Hospitalier de Lunéville, Lunéville, France
  4. 4Société ARCOSA, Limeil Brévannes, France
  1. Correspondence to Dr Edith Dufay, Pôle de Logistique Médicale, Service de pharmacie, Centre Hospitalier de Lunéville, 6 rue Girardet, Lunéville 54300, France; edufay{at}ch-luneville.fr

Abstract

Objective This study was designed to assess the clinical impact of medication reconciliation using two criteria: the number of inpatients who had experienced at least one medication error; the severity of the potential harm associated with these detected errors.

Method The study was a prospective observational one. The eligible population included patients aged 65 and over subjected to medication reconciliation at admission. The potential severity of medication errors was evaluated independently by the physician in charge of the patient and by the pharmacist involved in the medication reconciliation process. Severity assessment took account of the drug(s) involved in the error, the type of medication error, and the patient's clinical and biological data.

Results From January 2011 to September 2012, 1799 medication errors were recorded among the 1670 patients subjected to medication reconciliation who were hospitalised from the emergency department. At least one medication error occurred for 744 (44.6%) of these patients. There were 87 medication errors associated with potentially major severity (5.6%). These concerned 67 patients (4.2%). The most prevalent error was omission. Cardiovascular and anticoagulant drugs were the drugs most frequently involved in these serious medication errors. Arrhythmia, haemorrhage, thrombosis, hyperglycaemia and hypoglycaemia were identified as the most likely harms that could have occurred.

Conclusions The detection of cases of serious potential harm shows the clinical impact of medication reconciliation. It would be interesting to perform a multicentred assessment using indicators such as the number of inpatients experiencing at least one serious medication error. This could help to promote medication reconciliation as essential for patient safety.

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