Evaluación de la conciliación de la medicación en una Unidad de Traumatología

Pascual, O.; Real, Juliana Monte; Uriarte, María; Larrodé, I; Alonso, Yolanda Muñoz; Abad, M.R.

doi:10.1016/j.recot.2014.07.003

Cited by 9 publications

(10 citation statements)

References 12 publications

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“…Previous studies have shown that medication discrepancies at admission can be decreased with the help of a clinical pharmacist before patient admission [14,21,22]. Indeed, without this help, studies estimate that 48.8 to 60.3% of patients have at least one UMD at surgery admission [17,23,24]. These results are consistent with our previous study that found 53% of patient had at least one UMD without PA-BPMH.…”

Section: Discussionsupporting

confidence: 89%

“…Among the UMD, the most common was medication omission as identified in previous studies [22][23][24][25]. These UMD were related with medication additions or modifications by other physicians (mostly antihypertensive medication) occurring between anesthesiologist consultation and admission, for example, when patients have the cardiology consultation during this period.…”

Section: Discussionmentioning

confidence: 96%

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Impact of a preoperative pharmaceutical consultation in scheduled orthopedic surgery on admission: a prospective observational study

Renaudin

Leguelinel-Blache

Choukroun

et al. 2020

BMC Health Serv Res

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Background: Medication errors have a high prevalence in surgery and management of home medication is strongly involved in these errors. In scheduled surgery, the preoperative consultation is a privileged time to inform the patient about the management of her/his home medication before admission. This study assessed the impact of a pre-anesthesia best possible medication history (PA-BPMH) on admission. The PA-BPMH was performed by a clinical pharmacist prior to the anesthesia consultation for anesthesiologists to prescribe admission medical orders for scheduled orthopedic surgery patients. Methods: This was a prospective observational study which was carried out in an orthopedic surgery department. All patients over 18 years old with an elective orthopedic surgery were eligible except ambulatory surgery patients. The pharmacist registered the PA-BPMH into the software making it available for anesthesiologists for the preadmission medication order. Finally, a medication reconciliation was performed at admission. The main outcome was the percentage of patients with at least one unintended medication discrepancy (UMD) at admission. The nature, potential clinical impact and acceptance rate of each UMD detected were assessed. Also, the PA-BPMH process was described and patients and anesthesiologists satisfaction was evaluated. Results: A total of 455 patients had a pharmaceutical consultation. Medication reconciliation was performed at admission for 360 patients. Overall, at least one UMD was observed in 13.0% of patients (n = 47). A total of 63 UMD were detected. The most common type of UMD was omission (25.4%) and incorrect drug (23.8%).Two UMD (3.2%) were evaluated as life threatening. All the UMD detected were corrected on the admission medication order. Conclusion: A preoperative pharmacist-anesthesiologist teamwork seems to improve the safety of perioperative management of home medication for scheduled orthopedic surgery patients. This process needs a randomized clinical trial across a wider range of surgeries before its implementation.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 96%

Impact of a preoperative pharmaceutical consultation in scheduled orthopedic surgery on admission: a prospective observational study

Renaudin

Leguelinel-Blache

Choukroun

et al. 2020

BMC Health Serv Res

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“…Pascual et al studied the rate of medication reconciliation discrepancies in a trauma unit at a tertiary care hospital in Spain. This was a cross-sectional observational study in 164 patients over one and half months [19]. Patients were included if they were at least 18 years of age and were excluded if their medication history could not be obtained by clinical history (i.e., comatose or altered mental status) or if Spain’s National Health System pharmacy records were not available for a medication comparison.…”

Section: Resultsmentioning

confidence: 99%

“…This, coupled with the increasing availability of medications such as direct anticoagulants, which cannot be clinically detected at this time, makes accurate medication reconciliation in trauma vital and any errors, potentially high risk. In this systematic review, all four articles demonstrated poor accuracy of medication reconciliation in the trauma setting—4% accuracy [18] and high discrepancy rate [19]. Congruence of anticoagulant medication lists determined by EMS or hospital providers was also low [24], and medications were frequently omitted or incomplete [18, 19].…”

Section: Discussionmentioning

confidence: 99%

“…An admission medication reconciliation requires time—on average 58.4 min with a cooperative patient—and costs a minimum of $55.91 per patient for a pharmacist to complete [13]. Other challenges include health illiteracy, lack of appropriate staffing, complex medication names and regimens, and polypharmacy with increasing age [16–19]. The attribution and impact of medication errors as well as prevention of errors using current medication reconciliation can be difficult to determine [4, 18, 20, 21].…”

Section: Introductionmentioning

confidence: 99%

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Medications and patient safety in the trauma setting: a systematic review

et al. 2019

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Background Medication errors account for the most common adverse events and a significant cause of mortality in the USA. The Joint Commission has required medication reconciliation since 2006. We aimed to survey the literature and determine the challenges and effectiveness of medication reconciliation in the trauma patient population. Materials and methods We conducted a systematic review of the literature to determine the effectiveness of medication reconciliation in trauma patients. English language articles were retrieved from PubMed/Medline, CINAHL, and Cochrane Review databases with search terms “trauma OR injury, AND medication reconciliation OR med rec OR med rek, AND effectiveness OR errors OR intervention OR improvements.” Results The search resulted in 82 articles. After screening for relevance and duplicates, the 43 remaining were further reviewed, and only four articles, which presented results on medication reconciliation in 3041 trauma patients, were included. Two were retrospective and two were prospective. Two showed only 4% accuracy at time of admission with 48% of medication reconciliations having at least one medication discrepancy. There were major differences across the studies prohibiting comparative statistical analysis. Conclusions Trauma medication reconciliation is important because of the potential for adverse outcomes given the emergent nature of the illness. The few articles published at this time on medication reconciliation in trauma suggest poor accuracy. Numerous strategies have been implemented in general medicine to improve its accuracy, but these have not yet been studied in trauma. This topic is an important but unrecognized area of research in this field.

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