Ana M de Andrés-Lázaro1, Daniel Sevilla-Sánchez2, M del Mar Ortega-Romero3, Carles Codina-Jané4, Beatriz Calderón-Hernanz5, Miquel Sánchez-Sánchez3. 1. Servicio de Farmacia, Hospital Clínic de Barcelona, Barcelona, España. Electronic address: ana.de.andres@gmail.com. 2. Servicio de Farmacia, Consorci Hospitalari de Vic, Vic, Barcelona, España. 3. Área de Urgencias, Hospital Clínic de Barcelona, Barcelona, España. 4. Servicio de Farmacia, Hospital Clínic de Barcelona, Barcelona, España. 5. Servicio de Farmacia, Hospital Son Llàtzer, Palma de Mallorca, España.
Abstract
BACKGROUND AND OBJECTIVE: To assess the accuracy of pharmaceutical anamnesis obtained at the Emergency Department (ED) of a tertiary referral hospital and to determine the prevalence of medication reconciliation errors (RE). MATERIAL AND METHOD: This was a single-center, prospective, interventional study. The home medication list obtained by a pharmacist was compared with the one recorded by a doctor to identify inaccuracies. Subsequently, the home medication list was compared with the active prescription at the ED. All unexplained discrepancies were checked with the doctor in charge to evaluate if a RE has occurred. An univariate analysis was performed to identify factors associated with RE. RESULTS: The pharmacist identified a higher number of drugs than doctors (6.89 versus 5.70; P<0.05). Only 39% of the drugs obtained by doctors were properly written down in the patient's record. The main cause of discrepancy was omission of information regarding the name of the drug (39%) or its dosage (33%). One hundred and fifty-seven RE were identified and they affected 85 patients (43%), mainly related to information omission (62%). Age and polymedication were identified as main risk factors of RE. The presence of a caregiver or relative in the ED was judged to be a protective factor. No relationship was found between inaccuracies in the registries and RE. CONCLUSIONS: The process of obtaining a proper pharmaceutical anamnesis still needs improvement. The pharmacist may play a role in the process of obtaining a good quality anamnesis and increase patient safety by detecting RE. Better information systems are needed to avoid this type of incidents.
BACKGROUND AND OBJECTIVE: To assess the accuracy of pharmaceutical anamnesis obtained at the Emergency Department (ED) of a tertiary referral hospital and to determine the prevalence of medication reconciliation errors (RE). MATERIAL AND METHOD: This was a single-center, prospective, interventional study. The home medication list obtained by a pharmacist was compared with the one recorded by a doctor to identify inaccuracies. Subsequently, the home medication list was compared with the active prescription at the ED. All unexplained discrepancies were checked with the doctor in charge to evaluate if a RE has occurred. An univariate analysis was performed to identify factors associated with RE. RESULTS: The pharmacist identified a higher number of drugs than doctors (6.89 versus 5.70; P<0.05). Only 39% of the drugs obtained by doctors were properly written down in the patient's record. The main cause of discrepancy was omission of information regarding the name of the drug (39%) or its dosage (33%). One hundred and fifty-seven RE were identified and they affected 85 patients (43%), mainly related to information omission (62%). Age and polymedication were identified as main risk factors of RE. The presence of a caregiver or relative in the ED was judged to be a protective factor. No relationship was found between inaccuracies in the registries and RE. CONCLUSIONS: The process of obtaining a proper pharmaceutical anamnesis still needs improvement. The pharmacist may play a role in the process of obtaining a good quality anamnesis and increase patient safety by detecting RE. Better information systems are needed to avoid this type of incidents.
Authors: Ana Juanes; Noe Garin; Maria Antonia Mangues; Sergio Herrera; Mireia Puig; Maria Jose Faus; Maria Isabel Baena Journal: Eur J Hosp Pharm Date: 2017-02-23