Medication reconciliation in emergency department - the role of clinical pharmacist

Objective: To classify the frequencies and types of pharmaceutical interventions related to medication reconciliation performed in the hospital emergency room. Methods: This is a retrospective sectional study of medication reconciliation carried out in the emergency department of a referral hospita...

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Autores principales:	Amanda V. BARBOSA, Daniele S. SZPAK, Pedro P. CHRISPIM
Formato:	article
Lenguaje:	EN PT
Publicado:	Sociedade Brasileira de Farmácia Hospitalar e Serviços de Saúde 2021
Materias:	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/0f63d59147c84b99ad068254fceb79b3
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spelling	oai:doaj.org-article:0f63d59147c84b99ad068254fceb79b32021-11-28T02:43:31ZMedication reconciliation in emergency department - the role of clinical pharmacist10.30968/rbfhss.2021.121.05962179-59242316-7750https://doaj.org/article/0f63d59147c84b99ad068254fceb79b32021-03-01T00:00:00Zhttps://www.rbfhss.org.br/sbrafh/article/view/596https://doaj.org/toc/2179-5924https://doaj.org/toc/2316-7750 Objective: To classify the frequencies and types of pharmaceutical interventions related to medication reconciliation performed in the hospital emergency room. Methods: This is a retrospective sectional study of medication reconciliation carried out in the emergency department of a referral hospital in cardiology from June 11 to August 11, 2019. All patients admitted to the sector at the corresponding period and that have been reconciled were selected for the study. Patients’ home medications were classified according to the Anatomical Therapeutic Chemical Classification and as reconciled, not reconciled or reconciled after pharmaceutical intervention. Types of pharmaceutical interventions considered: suggestions for correcting the omission of patients’ home medications, dose or frequency. Interventions were classified as accepted or not accepted. The patients were divided into two groups: no discrepancies or intentional discrepancies (G1) and unintentional discrepancies (G2). The groups were compared using the Student’s T test (continuous data) and chi-square (x2) or Fisher’s exact test (categorical variables), considering statistical significance values of p <0.05. Results: 182 admissions were analyzed, with an average number of patient’s home medications use of 4.9 ± 3.6 drugs per patient. Of the 900 patients’ home medications, discrepancies were found in 227 medications on medical prescription of admission at the emergency room, being 48.9% intentional discrepancies and 51.1% unintentional discrepancies. Regarding unintentional discrepancies, 81% were due to the medication’s omission correction on the medical prescription; 9.5% were correction of divergent dose of patients’ home medications and frequency of administration respectively and all were adjusted after pharmaceutical intervention. 139 pharmaceutical interventions were performed to correct medication discrepancies, with 83.5% of acceptance by medical staff. Among all the analyzed medications, 51.8% had at least one registration failure by medical and/or nursing staff. Conclusion: The presence of the pharmacist in the emergency room reduced the incidence of unintentional discrepancies related to medication reconciliation, through interventions to correct medication omissions, dose and frequency, being an important element for patient safety. Amanda V. BARBOSA Daniele S. SZPAK Pedro P. CHRISPIM Sociedade Brasileira de Farmácia Hospitalar e Serviços de SaúdearticlePublic aspects of medicineRA1-1270Pharmacy and materia medicaRS1-441Therapeutics. PharmacologyRM1-950ENPTRevista Brasileira de Farmácia Hospitalar e Serviços de Saúde, Vol 12, Iss 1 (2021)
institution	DOAJ
collection	DOAJ
language	EN PT
topic	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950
spellingShingle	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950 Amanda V. BARBOSA Daniele S. SZPAK Pedro P. CHRISPIM Medication reconciliation in emergency department - the role of clinical pharmacist
description	Objective: To classify the frequencies and types of pharmaceutical interventions related to medication reconciliation performed in the hospital emergency room. Methods: This is a retrospective sectional study of medication reconciliation carried out in the emergency department of a referral hospital in cardiology from June 11 to August 11, 2019. All patients admitted to the sector at the corresponding period and that have been reconciled were selected for the study. Patients’ home medications were classified according to the Anatomical Therapeutic Chemical Classification and as reconciled, not reconciled or reconciled after pharmaceutical intervention. Types of pharmaceutical interventions considered: suggestions for correcting the omission of patients’ home medications, dose or frequency. Interventions were classified as accepted or not accepted. The patients were divided into two groups: no discrepancies or intentional discrepancies (G1) and unintentional discrepancies (G2). The groups were compared using the Student’s T test (continuous data) and chi-square (x2) or Fisher’s exact test (categorical variables), considering statistical significance values of p <0.05. Results: 182 admissions were analyzed, with an average number of patient’s home medications use of 4.9 ± 3.6 drugs per patient. Of the 900 patients’ home medications, discrepancies were found in 227 medications on medical prescription of admission at the emergency room, being 48.9% intentional discrepancies and 51.1% unintentional discrepancies. Regarding unintentional discrepancies, 81% were due to the medication’s omission correction on the medical prescription; 9.5% were correction of divergent dose of patients’ home medications and frequency of administration respectively and all were adjusted after pharmaceutical intervention. 139 pharmaceutical interventions were performed to correct medication discrepancies, with 83.5% of acceptance by medical staff. Among all the analyzed medications, 51.8% had at least one registration failure by medical and/or nursing staff. Conclusion: The presence of the pharmacist in the emergency room reduced the incidence of unintentional discrepancies related to medication reconciliation, through interventions to correct medication omissions, dose and frequency, being an important element for patient safety.
format	article
author	Amanda V. BARBOSA Daniele S. SZPAK Pedro P. CHRISPIM
author_facet	Amanda V. BARBOSA Daniele S. SZPAK Pedro P. CHRISPIM
author_sort	Amanda V. BARBOSA
title	Medication reconciliation in emergency department - the role of clinical pharmacist
title_short	Medication reconciliation in emergency department - the role of clinical pharmacist
title_full	Medication reconciliation in emergency department - the role of clinical pharmacist
title_fullStr	Medication reconciliation in emergency department - the role of clinical pharmacist
title_full_unstemmed	Medication reconciliation in emergency department - the role of clinical pharmacist
title_sort	medication reconciliation in emergency department - the role of clinical pharmacist
publisher	Sociedade Brasileira de Farmácia Hospitalar e Serviços de Saúde
publishDate	2021
url	https://doaj.org/article/0f63d59147c84b99ad068254fceb79b3
work_keys_str_mv	AT amandavbarbosa medicationreconciliationinemergencydepartmenttheroleofclinicalpharmacist AT danielesszpak medicationreconciliationinemergencydepartmenttheroleofclinicalpharmacist AT pedropchrispim medicationreconciliationinemergencydepartmenttheroleofclinicalpharmacist
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Medication reconciliation in emergency department - the role of clinical pharmacist

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