Background Medicines reconciliation is done to avoid errors in patient treatment such as omissions, duplications, dosing errors, drugs not included in the hospital formulary or drug interactions. Admission to hospital is one of the best times to reconcile medicines for patients with multiple comorbidities.
Purpose To analyse the pharmacist’s intervention in the medicines reconciliation process in the Emergency Department of a General Hospital.
Materials and Methods Prospective observational study in the Emergency Department (ED) of a General Hospital in October 2011 to September 2012. We included all patients admitted to the ED of our hospital whose medical orders (MOs) contained a conflict of medicines. When medical or nursing staff detected a conflict they sent the prescriptions to the unit dose drugs distribution system (UDDDS) and the pharmacist checked the drugs taken by the patient upon admission. All pharmaceutical interventions were recorded at the Pharmacy Department.
Results During the study period 969 MOs were received at the UDDDS and the pharmacist interventions were: 344 (35.5%) exchanged medicines not included in the hospital formulary for other alternatives, 219 (22.6%) exchanged to therapeutic equivalents, 167 (17.2%) exchanged to a brand of the same drug stocked in the hospital, 174 (18%) no alternative dosage forms, 24 (2.5%) interventions for errors in dosing regimen, 17 (1.8%) checked the parenteral or oral route, 7 (0.7%) prevented duplication of treatment and 17 (1.8%) other interventions.
Conclusions The role of the pharmacist in medicines reconciliation at patient admission increases coordination between different health care providers and maybe improves the global quality of care.
No conflict of interest.
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