5PSQ-163 Medication reconciliation in an emergency department

2019 
Background Medication errors lead to higher morbidity, mortality and expenditure. The likelihood of mistakes is higher in the Emergency Department (ED). Purpose To determine the incidence, the type of discrepancies and reconciliation errors (RE) upon admission to an ED, and the drugs involved. Material and methods Prospective observational study, including patients admitted to the ED pending hospitalisation, during a period of 3 weeks (9–27 April 2018). The variables collected were: sex, age, number of home medications, number of discrepancies justified by the patient’s clinical evolution (DJ) and not justified requiring clarification (DNJ), type of RE detected according to the Consensus Statement of the Spanish Society of Hospital Pharmacy and drugs involved. Programme coverage indicator, quality prescription indicators and medication reconciliation process indicators were calculated. The medication reconciliation process (MRP) was carried out through a clinical interview with the patient/carer, and the data obtained from the electronic clinical history and the primary care electronic records. Results MRP was performed in 61 of the 216 patients admitted (coverage rate of 28.24%). 55.74% were males, with an average age of 70.61±14.86 years (72.13%>65 years). The median of home medications was 8 (range 1–18). Ninety-three discrepancies were detected, of which 22.58% were DJ, while the remaining 77.42% were considered DNJ. The quality indicators of the prescription were determined, obtaining the following results: 57.38% patients with RE, 42% medications with RE and 1.20 RE per patient. Regarding quality indicators of the MRP, the detected RE were 58.33%, and were classified into: 37 (88.10%) medication omissions, four (9.52%) dose errors, and one (2.38%) wrong medication. The drugs involved were: 19 (45.24%) lipid modifying agents, five (11.90%) antidepressants, four (9.52%) thyroid hormones, four (9.52%) drugs used in benign prostatic hyperplasia, two (4.76%) antipsychotics, two (4.76%) anti-glaucoma drugs and miotics, two (4.76%) insulins and analogues, one (2.38%) beta-blocking agents, one (2.38%) digitalis glycosides, one (2.38%) organic nitrates and one (2.38%) vitamin D and analogues. Conclusion The RE affected more than half of the patients admitted to the ED. The most prevalent discrepancy was the omission of medication and the drugs most implicated were statins. References and/or acknowledgements No conflict of interest.
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