Article Text
Abstract
Background and Importance The Institute for Health care Improvement (IHI) defines Medication Reconciliation as the formal process of obtaining a complete list of the patient‘s medication prior to admission, comparing it with the one that has been prescribed in the health centre, in transfers and medical discharge.
Reconciliation errors occur in 50% of patients admitted to hospitals and have been identified by organisations such as the WHO or NICE as a priority practice for patient safety.
Aim and Objectives The aim of the study is to describe the pharmaceutical interventions related to medication reconciliation in an Emergency Department at the admission process, the degree of acceptance by clinicians and the most commonly pharmacological groups involved in these interventions.
Material and Methods It was a descriptive and transversal study conducted in the Emergency Department of a Regional Hospital (<150 beds) during February 2021-July 2023.
A review of usual medications of patients admitted during the night was performed daily. Reconciliation interventions were registered in a database (Microsoft Excel (r)) and classified in five types: omission, dose, therapeutic equivalents, drug not necessary and adverse event. Drugs involved were classified according to the Anatomic Therapeutic Classification (ATC).
Results Six hundred and eighty-two pharmaceutical interventions were carried out, of which 59% were of the medication reconciliation type. The degree of acceptance by the clinicians was 75%.
The medication reconciliation interventions were made in 228 patients of whom 55% were male. The mean age of the patients was 75.86 years (range 20–97).
The most frequent reconciliation errors were related to the omission of the drug (46.03%), dosage errors (37.37%) and therapeutic equivalents (6.93%).
Drugs most frequently involved in pharmaceutical interventions belonged to the following ATC groups: cardiovascular system- C (43.06%), nervous system – N (33.41%), blood- B (7.17%) and systemic hormonal preparations-H (5.69%).
Conclusion and Relevance More than a half of the interventions were related to medication reconciliation which shows that this process is important at hospital admission. The high degree of acceptance by clinicians shows that the pharmacist should be part of a multidisciplinary team and can contribute improving patients’ safety.
Conflict of Interest No conflict of interest.