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4CPS-228 Impact and acceptance of pharmaceutical interventions for early medication reconciliation in the emergency department
  1. A Suárez-Lledó1,
  2. J Martínez Casanova1,
  3. C Porredón Antelo1,
  4. N Mas Bauza1,
  5. J Jacob Rodríguez2,
  6. P Malchair2,
  7. MB Badía Tahull1
  1. 1Bellvitge University Hospital, Pharmacy Department, L’hospitalet De Llobregat, Spain
  2. 2Bellvitge University Hospital, Emergency Department, L’hospitalet De Llobregat, Spain


Background and Importance Emergency departments (EDs) are characterised by high care load, staff rotation and critical situations that require rapid decisions. Early conciliation in high-risk patients may improve patient safety during care transitions.

Aim and Objectives To establish a protocol of early medication reconciliation process in ED and re-evaluation in patients with complexity criteria (validated by Hohl et al.). Medication review by referent pharmacists in ED and their interventions were evaluated for acceptancy rate and quality.

Material and Methods A protocol of medication reconciliation was developed based on the ‘Consensus document of REDFASTER and SEMES-FARMA group for Medication reconciliation in ED’. Reinitiation priority of each pharmacologic group was evaluated individually, considering the benefit of their reconciliation during ED stay and defining those drugs whose reconciliation is recommended to be done in the first 12 hours.

This protocol was implemented in a third-level hospital with 330 average daily ED assistance and five daily hours of presential pharmaceutical activity.

ED pharmacists made individual recommendations: early reconciliation was performed in all patients reviewed, and remaining conciliation interventions were performed in patients with stays longer than 12 hours and complexity criteria.

Results The chronic medication of 1,645 patients was reviewed over a 2-month period: 475 recommendations of early reconciliations were given in 337 patients and physicians accepted 248 (52.32%). Demographic data: 73 (13,64) average age, 196 (58,16%) men. Mean time of recommendations from arrival to ED was 6.73 hours. Time average of reintroduction by physicians was 10,38h. Within the first 12 hours, 179 drugs (72.18%) were introduced.

Forty pharmacological groups were recommended to be reintroduced: insulin and analogues (A10A) and beta blockers (C07A) were the most recommended (N=236), following others: antithrombotic (B01A) (N=37), Calcium channel blockers (C08C) (N=34), immunosuppressant (L04A) (N=37), antiepileptic (N03A) (N=33), nitrates (C01DA) (N=18).

A total of 402 patients with stays longer than 12 hours and complexity criteria were reviewed, leading to 171 recommendations.

Pharmaceutical interventions were analysed over a period of 2 months comparing before and after protocol application: variety of intervention were similar, but quantity increased after protocol implementation (531 vs 1043 interventions).

Conclusion and relevance Early conciliation led to early reintroduction of priority drugs, ensuring safety and quality across care transitions and with a high rate acceptance among physicians.

Conflict of Interest No conflict of interest.

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