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5PSQ-007 A review of medication reconciliation in the perioperative period: variables that lead to medication errors
  1. DJ Boardman González,
  2. L Rubio Alonso,
  3. S Canales Ugarte,
  4. V Lafarga Lapieza,
  5. P Hernando Martínez,
  6. D Barreda Hernández
  1. Virgen de la Luz Hospital, Pharmacy Department, Cuenca, Spain


Background and Importance Medication reconciliation (MR) builds the bridge between the patients’ current medication, and their received treatment during hospitalisation. Pharmacists have an active role in preventing omissions, duplications, dosing errors, or drug interactions; this is all the more evident when it comes to the perioperative period, where a correct management on medication becomes imperative to the patients’ safety.

Aim and Objectives To evaluate which pharmacological groups are prone to lead to medication errors during the perioperative period and to find a possible correlation between said errors and the patients’ demographic factors and prescription-based factors.

Material and Methods Prospective observational study from July to September 2023 in a second-level hospital. We reviewed patients’ prescriptions in traumatology, ophthalmology, urology and general surgery wards, and selected those with chronic medication with clinical evidence on their reconciliation during the perioperative period. We divided the perioperative period into pre-op and post-op, and analysed discrepancies in MR. Variables such as patients’ age, gender, duration of admission and number of prescribed medications were taken into account. To obtain this information, we used Mambrino XXI® (electronic prescription software), and FarmaTools® for pharmaceutical validation processes.

Results Fifty-two patients’ prescriptions were analysed and a total of 214 medications were reviewed. The median age for this group was 67 years, where 56% were male. The median number of medications per patient was four (1–13). The duration of admission had a median of 5 days (2–46 days). 50% of admitted patients’ MR was successful on pre-op processes, in contrast to 42.3% in post-op processes. When reviewing the percentage of errors in variables included in the study, we found that: Statins (65% pre-op, 55% post-op) and diuretics (50% pre-op, 36% post-op) are the most affected groups. Duration of admission >5 vs. <5 days (64,7% vs. 65,7%). Number of prescriptions >4 vs. <4 (63% vs. 70%).

Conclusion and Relevance Although MR in the perioperative period can be a rigorous process; it is a must-have in any hospital to guarantee patients’ safety. Pharmaceutical interventions are key to prevent risks due to medication errors; especially in those prone to error. A more precise statistical model is needed to figure out which variables lead to medication errors in the perioperative period.

Conflict of Interest No conflict of interest.

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