Article Text

Download PDFPDF
Development and validation of a ready-to-use score to prioritise medication reconciliation at patient admission in an orthopaedic and trauma department
  1. Thibault Vallecillo1,
  2. Florian Slimano1,2,
  3. Marie Moussouni1,
  4. Xavier Ohl3,4,
  5. Morgane Bonnet1,
  6. Christophe Mensa3,
  7. Dominique Hettler1,
  8. Lukshe Kanagaratnam5,
  9. Céline Mongaret1,4
  1. 1 Pharmacy, CHU Reims, Reims, France
  2. 2 MEDyC UMR CNRS/URCA n°7369, Reims Champagne-Ardenne University Faculty of Pharmacy, Reims, France
  3. 3 Orthopaedic Surgery, CHU Reims Pôle Locomoteur, Reims, France
  4. 4 EA 4691, Reims Champagne-Ardenne University Faculty of Pharmacy, Reims, France
  5. 5 Reserch and innovation, CHU Reims, Reims, France
  1. Correspondence to Dr Thibault Vallecillo, Pharmacy, CHU Reims, Reims 51092, France; tvallecillo{at}


Objective Medication reconciliation (MR) is recognised as an important tool in preventing medication errors such as unintentional discrepancies (UDs). The aim of this study was to identify independent predictive factors of UDs during MR at patient admission to an orthopaedic and trauma department. The secondary objective was to build and validate a ready-to-use score to prioritise patients.

Method A retrospective study was performed on 3.5 years of pharmacist-led MR in the orthopaedic and trauma department of a large university teaching hospital. Independent predictors of UD were identified by multivariable logistic regression. A priority score to identify patients at risk of at least one UD was constructed from the odds ratios of the risk factors, and validated in a separate cohort. Performance was assessed with sensitivity, specificity, C-statistic and Hosmer-Lemeshow goodness-of-fit.

Results In total, 888 patients were included and 387 UDs were identified, mainly drug omissions (65.1%). Five independent predictors of UD were identified: age >75 years (OR 2.05, 95% CI 1.41 to 3.00; p<0.001), admission during school holidays (OR 1.69, 95% CI 1.17 to 2.44; p=0.005), female gender (OR 2.20, 95% CI 1.53 to 3.16; p<0.001), emergency hospitalisation (OR 2.05, 95% CI 1.45 to 2.92; p<0.001), and ≥5 medications on the best possible medication history (BPMH) (OR 3.29, 95% CI 2.20 to 4.94; p<0.001). Based on these predictors, a priority score ranging from 0 to 10 was built and internally and externally validated (C statistic 0.72, 95% CI 0.67 to 0.76).

Conclusions This study confirms the high prevalence of UD in patients admitted to orthopaedic and trauma surgery departments. Five independent predictive factors of UD during MR were identified (female gender, emergency hospitalisation, hospitalisation during school holidays, age ≥75 years, and ≥5 medicines on the BPMH). The developed risk score will help to prioritise MR among patients at risk of medication error and is ready-to-use in other orthopaedic and trauma departments.

  • clinical pharmacy
  • health & safety
  • quality in health care
  • time management
  • trauma management

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

View Full Text