Medication discrepancies in a hospital in Southern Brazil: the importance of medication reconciliation for patient safety

Soares, Alessandra de Sá; Trevisol, Daisson José; Schuelter‐Trevisol, Fabiana

doi:10.1590/s2175-979020200004181064

Cited by 5 publications

(2 citation statements)

References 25 publications

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“…[32,33] Some studies in developing countries have shown that patients taking cardiovascular medications during the transition period are more likely to suffer from medication bias, but the MD in CVD patients has not been specifically explored. [34,35] The variation in the incidence of MD may be related to the types of the disease and differences in the follow-up time of the MD. For example, pravastatin, the drug with the highest incidence of single-type MD (50.94%), needs to be taken before bed; hence, many patients easily forget to take the medicine and develop MD.…”

Section: Discussionmentioning

confidence: 99%

Effect of frailty on medication deviation during the hospital-family transition period in older patients with cardiovascular disease: An observational study

Liang,

Feng,

Zhu

et al. 2024

Medicine

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Studies have shown that frailty increases cardiovascular disease (CVD) incidence in older patients and is associated with poor patient prognosis. However, the relationship between medication deviation (MD) and frailty remains unclear. This study aimed to explore the influence of frailty on MD during the hospital-family transition period among older patients with CVD. Between February 2022 and February 2023, 231 older people CVD patients were selected from a class III hospital in Nantong City using a multi-stage sampling method. A general information questionnaire was used to collect the socio-demographic characteristics of the participants prior to discharge, the frailty assessment scale was used to assess the participants frailty, and a medication deviation instrument was used to assess the participants MD on the 10th day after discharge. Propensity score matching was used to examine the effect of frailty on MD in older patients with CVD during the hospital-family transition period. The incidences of frailty and MD were 32.9% (76/231) and 75.8% (175/231), respectively. After propensity score matching, the risk of MD in frail patients with CVD was 4.978 times higher than that in non-frail patients with CVD (95% CI: [1.616, 15.340]; P = .005). Incidences of frailty and MD during the hospital-family transition period are high in older patients with CVD, and frailty has an impact on MD. Medical staff in the ward should comprehensively examine older patients with CVD for frailty and actively promote quality medication management during the hospital-family transition period to reduce MD occurrence and delay disease progression.

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Section: Discussionmentioning

confidence: 99%

Effect of frailty on medication deviation during the hospital-family transition period in older patients with cardiovascular disease: An observational study

Liang,

Feng,

Zhu

et al. 2024

Medicine

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“…Therapeutic duplicity or incompatibility may increase the risk of adverse reactions and interactions. When detected the pharmacist or physician must adjust the therapeutic regimens, scheduling the drugs in use or change the prescription [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Validation of a computerized decision support system to review pharmacotherapy treatment: scheduling guidelines

Zapelini

Galato

Alano

et al. 2022

BMC Med Inform Decis Mak

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Background The review of pharmacotherapy can be conceptualized as a service in which the drugs used by the patient are reviewed to control the risks as well as to improve the results of the drug therapy, detecting, solving, and preventing issues associated with the drug, readjusting the doses and times (schedule) so that the treatment is not incompatible or in duplicity. Methods The aim of the study was to validate an intelligent information system, which was developed to assist the scheduling activity in the pharmacotherapy review. The system used the concept of Genetic Algorithms. To validate the system, hypothetical cases were elaborated considering various aspects of pharmacotherapy such as underdose, overdose, drug interactions and contraindications. These cases were tested in the system and were also analyzed by pharmaceutical experts with clinical and research experience in the pharmacotherapy review process. The degree of agreement between the assessments of the appointments carried out by the pharmaceutical specialists and by the system were measured using the Kappa index with a 95% confidence interval. Results In detecting errors and make propositions, the system was able to identify 80% of errors, with pharmaceutical experts identifying between 20 and 70% of errors. In relation the results of kappa between the cases, the system had 87,3% of concordance, whereas the best pharmaceutical expert had 75,5% of concordance, considering the correct answer. Conclusion It can be concluded that with the methodology used, the investigation met the objectives and confirmed the system is effective for pharmaceutical review process. There are indications that the system can help in the Pharmacotherapy review process, being able to find prescription errors as well as to establish times for the use of medications according to the patient’s routine.

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Development and Application of a Computerized System for Medication Reconciliation in a Hospital Environment

Soares,

Espindola,

Rosa

et al. 2023

Preprint

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Introduction: The World Health Organization (WHO) is concerned with ensuring patient safety in all health services. Thousands of people suffer from errors and adverse events related to medications2. Hospitals lack financial conditions, human resources, infrastructure, and computerized support systems for the implementation of clinical pharmacy, pharmacovigilance and medication reconciliation services. The introduction of systems that help the rational use of medicines (RMU), which is one of the pillars of safety in health services, is very relevant, especially for patients and pharmacists. Objective: To develop and apply a computerized pharmaceutical decision support system for the medication reconciliation in a general hospital. Method: Study of the development and application of a digital tool, with a cross-sectional design, for the comparison between manual medication reconciliation performed by the pharmacist and medication reconciliation performed with a computerized support system. Results: In the medication reconciliation process, the computerized system reduced the time for analyzing prescriptions by eight minutes per patient. Of the 392 patients who were part of the sample, 97.7% used continuous medication at home. Among the list of home medications that were not prescribed in hospital prescriptions and identified through the system are: losartan (9.1%), levothyroxine (4.4%), metformin (3.6%), and medication for mental disorders. depression and anxiety such as: sertraline (2.9%), clonazepam (2.4%) fluoxetine (1.6%). Conclusion: The developed computerized system proved to be superior to the pharmacist's manual search during medication reconciliation and clinical pharmacy and can be a valuable tool in pharmaceutical care.

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Medication discrepancies in a hospital in Southern Brazil: the importance of medication reconciliation for patient safety

Cited by 5 publications

References 25 publications

Effect of frailty on medication deviation during the hospital-family transition period in older patients with cardiovascular disease: An observational study

Effect of frailty on medication deviation during the hospital-family transition period in older patients with cardiovascular disease: An observational study

Validation of a computerized decision support system to review pharmacotherapy treatment: scheduling guidelines

Development and Application of a Computerized System for Medication Reconciliation in a Hospital Environment

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