Therapeutic Reconciliation on Admission to Hospital in the Emergency Department

Abstract

Objectives: To evaluate the medication reconciliation procedure in the Emergency Department and to analyze the medication-related problems identified, their potential severity and the pharmaceutical interventions made during this process.

Methods: It was conducted a prospective and observational study in the Emergency Department of a tertiary care hospital. Data were collected during three months (April-June 2020). Priority criteria were developed in order to select patients with a higher risk of suffering reconciliation errors. The reconciliation process was carried out by means of: Electronic Medical Record, primary care pharmacotherapeutic history and electronic prescription in the Emergency Department. All discrepancies not justified by the physician were considered reconciliation errors and their potential severity was assessed according to the National Coordinating Council for Medication Error Reporting and Prevention.

Results: 23 patients were included, 13 were men. The average age was 77.8 years (SD 11.2). During the reconciliation process 116 discrepancies were found, 56 (48.3%) of which required clarification. 36 reconciliation errors were detected, these were due to: medication omission (n = 18; 50%), dosage error (n = 13; 36.1%) or administration frequency error (n = 5; 13.9 %). The uptake of these reconciliation interventions was 92.6%. In addition, 22 pharmaceutical interventions were performed with 100% acceptance.

Conclusions: The implementation of a medication reconciliation process in the Emergency Department prevented medication errors, most of them with clinical relevance. Besides, it improved the pharmacotherapeutic care of these patients.