Medication reconciliation and review for older emergency patients requires improvement in Finland

Abstract

Medication reconciliation and review at admission of older ED patients requires improvement in Finland.

Communication issues contributing to medication incidents: Mixed‐method analysis of hospitals’ incident reports using indicator phrases based on literature

“…The real incident number involving primary care might be higher, as Gracie et al (2014) observed that under half of hospital discharge summaries were accurate concerning medication. Schepel et al (2019) detected that nearly all patients admitted to hospital in Finland had discrepancies in their medication. Thus, attention must be paid to the communication pairs between units within the same organisation, but also between primary‐ and tertiary‐care units.…”

Collaborative Medication Reviews to Identify Inappropriate Prescribing in Pre-Admission Medications at Emergency Department Short-Term Ward

“…14 In a previous study from Finland (2019), ED admissions in two university hospitals were investigated, and CMR, including medication reconciliation, was conducted on 150 patients. 15 In the study, discrepancies in medication lists were observed in almost all study subjects (149/150). The CMRs also found a high number of medicationrelated problems in the study subjects.…”

“…10 For example, the geriatric ED guideline by The American College of Emergency Physicians (ACEP) suggests that CMRs should be initiated early in the ED. 11 However, only a few recent studies explored CMRs in the ED units [12][13][14][15] One of the recent studies investigated the effect of CMR among high-risk ED patients on the number of days patients spent in the hospital. 12 The patients in the CMR group spent fewer days in the hospital within 30 days of the ED visit than patients in the control group who received only medication reconciliation.…”

“…16,17 After 2005, CMRs have become more common in Finnish hospitals, although the progress has been relatively slow. 15,16 An inventory conducted by the Finnish Medicine Agency in 2015 identified 43 CMR procedures, of which almost half (n=22) were designed for older adults in primary care, being mostly established between 2013 and 2015. 16 Fifteen of the practices were reported from government or municipality funded hospitals; health care settings were not specified.…”

Identification de facteurs de risque d’erreur de prescription médicamenteuse aux urgences : optimisation d’une activité de conciliation médicamenteuse à l’UHCD

“…Néanmoins, nous avons inclus la totalité des patients ayant bénéficié d'une conciliation médicamenteuse à l'UHCD pendant la période d'inclusion, à l'exception des patients hospitalisés depuis plus de 72 heures le lundi, ou destinés à être hospitalisés dans un service bénéficiant déjà d'un service de conciliation (rhumatologie et cardiologie), qui étaient exclus d'emblée. Cela peut constituer un biais de sélection même si la taille de l'effectif est supérieure à d'autres études [6][7][8]13,16,19].…”