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PS-087 Reconciliation of chronic medicines in patients admitted to the urology service
  1. A Romero1,
  2. S Cobo2,
  3. A Padullés2,
  4. P Modamio1,
  5. EL Mariño1
  1. 1Universitat de Barcelona, Clinical Pharmacy and Pharmacotherapy Unit, Barcelona, Spain
  2. 2Hospital Universitari de Bellvitge, IDIBELL, Department of Pharmacy, Barcelona, Spain


Background Amongst other public health issues, patient safety is of great concern. According to the World Health Organisation, it has been estimated that 1 out of 10 patients in developed countries is harmed during hospital care. Medicines errors are one of the main causes of morbidity and medicines reconciliation has been proven to be an effective way of reducing morbidity.

Purpose To create and implement a pilot medicines reconciliation system for newly admitted patients and to evaluate the system’s viability.

Materials and methods A prospective study took place during July and August 2013 at a third level university hospital, piloting the new system. All the patients admitted for urology services were included. Reconciliation criteria were previously established with the medical team. Patients were interviewed and the pre-admission chronic medicines list (PAML) was revised. The PAML was reconciled with admission prescriptions using the electronic prescription program and consisted of chronically prescribed medicines and/or physician communication.

Results Of the 138 patients included, 23 did not have any chronic medicines, 34 missed the interview and 81 were interviewed. 74.1% of the patients (n = 81) were men, average age was 65 ± 12 years (range: 39–94) and stayed an average of 8.2 ± 8.4 days. Patients had 6.6 ± 3.7 chronic medicines (range: 1–18). Of all the drugs present during the medicines reconciliation (n = 530), only 42% were reinitiated. Interviews detected 62 discrepancies: 31 medicines on the PAML were discontinued, 11 were not included in the PAML and 20 had different dosage regimens. Throughout this process, the medical staff informed the pharmacist 28 times.

Conclusions The implementation of a reconciliation system is important to improve patient safety and risk management1. Thus, checking the PAML with patients is a necessity. Moreover, collaboration amongst member of the healthcare team is imperative for the viability of the system.


  1. Mueller SK et al. Arch Intern Med 2012;172:1057–69

  2. Redmond P et al. Fam Pract 2013;30:483-4

No conflict of interest.

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