Calidad de la recogida de la medicación domiciliaria en urgencias: discrepancias en la conciliación

Abstract

The percentage of patients that experienced reconciliation errors was high (86%), observing an important opportunity to improve at patient admission to the Emergency Department.

Evaluation of medication reconciliation in a trauma unit

“…14,21 In this regard, it was observed that those patients who took ≥5 drugs presented a significantly higher number of discrepancies, as the increase in the number of drugs favored the risk of errors during pharmacotherapeutic anamnesis, particularly among patients with cognitive problems. 6,9,13,14,22 Although emergency patients accounted for a minimal proportion of the total included, compared to other studies where such patients accounted for nearly 80% of the total, the higher rate of discrepancies observed among patients admitted through the Emergency Service could be justified by the idiosyncrasy of the Service itself: an environment with constant interruptions, where decisions need to be taken rapidly, with high healthcare pressure and with an acute problem as main priority. In addition, patients with programmed admissions often provide their usual home medication, which contributes to establish their current treatment with greater reliability.…”

“…8---10,24 Lastly, coinciding with other studies conducted at emergency and medical services, after adjusting for the different variables through logistic regression we detected that polymedication was the only factor which affected the presence of discrepancies in a statistically significant manner. 11,13 The results obtained showed some limitations due to the design of the study. The main such limitation was that being a transversal study made it impossible to know the time sequence of events.…”

“…However, the mean drug intake per patient was lower than that registered in most studies (around 7 drugs/patient) conducted at medical services and including older patients. 9,10,13,16 Regarding the rate of discrepancies in the reconciliation of medication, the published data varied widely: from 25.9% to 65% of patients with discrepancies, even reaching 70% of the prescribed medication. These differences could be due both to the different methodologies used and to the lack of homogeneity in terms of the criteria used to define discrepancy, as reported by a meta-analysis conducted in 2005.…”

Survey of pharmacy involvement in hospital medication reconciliation programs across the United States

“…Essential information often overlooked includes home medication (prescription, over-the-counter, and herbal), therapy duplication at discharge, and incorrect dosage form, strength, or frequency. 3 In a study by Soler-Giner et al, 4 medical errors were found in 86.8% of emergency departments without defined medication reconciliation programs. A recent study by Bishop et al 5 showed that two out of five patients on the hospitalist service have discrepancies in their medications at discharge that can be identified and corrected by pharmacist intervention.…”

Impacto de una aplicación informática en la mejora de la conciliación de la medicación al alta hospitalaria

“…No se ha podido demostrar si el número de fármacos que tomaba el paciente influye en la aparición o no de discrepancias, como ocurre en otros estudios en los que los pacientes con más fármacos tenían más discrepancias 9 .…”