Emergency Service, Hospital Clinical Trial
Official title:
OPTICONCIL: Implementation of Medication Reconciliation Process in an Emergency Department : Which Patients Should be Prioritized and How to Optimize Patients' Therapeutics?
Medication reconciliation has proven its efficiency in improving patients' care, especially
for emergency patients.
This study aimed to identify risk factors of unintended medication discrepancies (UMD) in an
emergency department. Secondary objectives were to identify the number and type of UMD,
correction rate of UMD and the impact of emergency department organisation on UMD.
Emergency patients are at high risk of medication errors, for different reasons: emergency
admission, patients who don't know their at-home treatment (polymedicated, cognitive
disorders, etc) and who don't have their medical prescriptions available.
Medication reconciliation has proven its efficiency in improving patients' care, especially
for emergency patients. However, prioritization is essential to ensure a better efficiency of
pharmaceutical resources.
In our center, a pharmacy resident has been assigned to medication reconciliation in the
emergency department since November 2017, in collaboration with a clinical pharmacist. Every
morning, 3 to 4 patients benefit from medication reconciliation (patients who will be
transfered to another unit within our hospital).
The main objective was to identify risk factors of unintended medication discrepancies (UMD)
in order to prioritize patients who will benefit from this newly implemented activity.
Secondary objectives were to identify the number and type of UMD, correction rate of UMD and
the impact of emergency department organisation on UMD.
All patients who beneficiated from medication reconciliation in the emergency department
between November 2017 and April 2018 were included. Were not included patients with a
medication reconciliation performed but transfered to another hospital right after the
emergency department visit.
This was a retrospective, monocentric, observational study. Number of patients required was
200. Variables collected were:
- demographics (age, sex, lifestyle, comorbidities),
- emergency care variables (date and time of medical care beginning, ambulance arrival,
adressing type, medical prescriptions availability, main diagnosis, date and hour of
medical prescriptions in the emergency department, prescriber (pharmacy/doctor),
destination unit of patients)
- organizational variables (number of daily emergency visits, number of patients
hospitalized within the emergency department),
- medical notes information on at-home treatment (number of missing information, of
incorrect information, number of prescriptions in at-home treatment)
- medication reconciliation variables (date of medication reconciliation, number of
sources of information needed, number of actual prescriptions in at-home treatment,
number of intended medication discrepancies, number and type of UMD, time needed for
medication reconciliation).
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