• Medicina clinica · Oct 2015

    Observational Study

    [Accuracy in the medication history and reconciliation errors in the emergency department].

    • Ana M de Andrés-Lázaro, Daniel Sevilla-Sánchez, M del Mar Ortega-Romero, Carles Codina-Jané, Beatriz Calderón-Hernanz, and Miquel Sánchez-Sánchez.
    • Servicio de Farmacia, Hospital Clínic de Barcelona, Barcelona, España. Electronic address: ana.de.andres@gmail.com.
    • Med Clin (Barc). 2015 Oct 5; 145 (7): 288-93.

    Background And ObjectiveTo 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 MethodThis 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.ResultsThe 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.ConclusionsThe 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.Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

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