5PSQ-114 Evaluation of pharmaceutical interventions performed on medication errors detected in the prescription

Background Pharmaceutical validation consists in verifying medical prescriptions (dosage, route of administration, pharmaceutical presentation) and checking the suitability of treatment in the approval indications, patient characteristics and domiciliary medication. Purpose To analyse the pharmaceutical interventions (PI) performed in the hospital and measure the degree of acceptance. Material and methods Prospective study that included all the PI performed during 3 months of follow-up (January to March 2018). Pharmaceutical interventions were realized through notes by the pharmacist in the electronic prescription. Clinical information was obtained from electronic clinical history with CernerMillenium. Interventions made in medication errors were selected for the study and registered in an Excel book for analysis. Variables collected: type of intervention, drug, therapeutic group, acceptance or rejection, and time of acceptance. Time to consider the PI accepted was 48 hours since the recommendation. Results During the period of study there were 611 PI. These were classified into different types of intervention: dosage mistakes (288), duplicities (129), wrong pharmaceutical presentation (43), sequential therapy (31), antibiotic recommendation according to the antibiogram (29), conciliation of pharmacotherapy at admission (22), interactions (22), non-indicated drug (22), allergies (21) and route of administration (seven). Dosage mistakes interventions (288) included: overdosing (127), underdosing (13), recommendation of renal insufficiency adjustment (141) and hepatic insufficiency adjustment (seven). From 611 PI, 275 were accepted, 226 rejected and 110 null because the patient received medical discharge during the evaluation period. The global acceptance was around 54%. Results of acceptance for different types of intervention were: allergies 71%, recommendations of anti-infective therapy-adjusting treatments with the antibiogram results 70%, duplicates 70%, non-indicated drug 60%, interactions 55%, wrong pharmaceutical presentation 50%, dosage mistakes 50%, conciliation of pharmacotherapy at admission 44%, sequential therapy 41% and wrong route of administration 33%. Evaluating the acceptance into categories of dosage mistakes: overdosing 57%, underdosing 38%, renal insufficiency 45% and hepatic insufficiency 29%. Conclusion Many medication errors occur that must be detected and corrected. The rate of acceptance is lower than expected, so it is important for pharmacists to specialise in different areas of knowledge to perform high-quality pharmaceutical interventions that can help physicians in electronic prescription and improve the safety of patients. References and/or acknowledgements No conflict of interest.