Gravedad de los errores de conciliación producidos en el servicio de urgencias en pacientes ancianos

2020 
espanolObjetivos. Analizar la gravedad de los errores de conciliacion (EC) producidos en el servicio de urgencias (SU) en pacientes que ingresan en una unidad de agudos de geriatria. Cuantificar y describir las discrepancias y los EC. Analizar los grupos farmacologicos y los factores de riesgo. Metodo. Estudio observacional prospectivo. Un farmaceutico realizo la historia farmacoterapeutica y comparo el tratamiento habitual con el prescrito en el SU, identifico discrepancias y posibles EC y un geriatra evaluo su gravedad. Resultados. Se incluyeron 351 pacientes, de los que 328 (93,8%) presentaron discrepancias, 151 pacientes (43,02%) presentaron al menos 1 EC. Se observaron 300 EC de los que 248 (82,7%) alcanzaron al paciente, y 27 EC (9%) produjeron dano reversible. No hubo ningun error que causase dano prolongado o mortal. Conclusiones. Los EC fueron frecuentes pero de escasa gravedad, y los danos que ocasionaron fueron reversibles. EnglishObjectives. To analyze the seriousness of medication reconciliation errors (MREs) in the treatment of older patients admitted to an emergency department’s acute geriatric unit. To identify and describe discrepancies, including the drug groups involved, and to explore risk factors. Methods. Prospective, observational 6-month study. A pharmacist recorded medications in each patient’s history and compared the patient’s usual treatment to the regimen prescribed in the emergency department; discrepancies were flagged for evaluation as possible MREs. A geriatric medicine specialist evaluated MRE seriousness. Results. Three hundred twenty-eight discrepancies were detected (93.8% of the total of 351 patients); 151 patients (43.02%) had at least 1 MRE. Three hundred MREs were identified, 248 (82.7%) reached the patient, and 27 (9%) caused reversible injury. No errors led to prolonged injury or death. Conclusions. MREs were common but not serious, and the injuries caused were reversible.
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