ABSTRACT
BACKGROUND: The care transition is the time when more medication errors occur. The aim of this study is to analyze the usefulness of a pharmacotherapeutic report model at hospital discharge to prevent medication errors and to simplify pharmacotherapy during a patient's transition from the hospital to primary care. METHODS: Prospective study including patients diagnosed with chronic obstructive pulmonary disease who were admitted to a short-stay unit or an emergency room. Relevant variables were extracted from the patients' clinical history and SPSS software was used to carry out the statistical analysis. Direct costs were also calculated. RESULTS: 79.3% of patients were polymedicated, 15.5% of patients were identified as nonadherent to the treatment, 12.1% were users of alternative therapies, and 10.3% had been prescribed drugs that could be monitored. In 32.8% of the reports, reference was made to the primary care pharmacists with a view to resolve any pharmacotherapeutic discrepancies. A total of 132 discrepancies were identified, the majority being related to medicinal requirements (necessary/unnecessary medication). The major cause of drug-related problems (DRPs) were prescription errors. The drugs that were mainly involved in the onset of DRPs belonged to the R group, and the degree of simplification of the pharmacotherapy was 7.6%. The total cost avoided with the reconciliation was 200/patient. CONCLUSION: A continuity program was implemented based on the drafting of a pharmacotherapeutic report, which allowed for detecting discrepancies and updating the patients' pharmacotherapeutic history, resulting in financial savings after its implementation.
Subject(s)
Medication Errors/prevention & control , Medication Reconciliation/methods , Patient Discharge , Pulmonary Disease, Chronic Obstructive/drug therapy , Cost Savings , Electronic Health Records , Female , Humans , Male , Pulmonary Disease, Chronic Obstructive/economicsABSTRACT
The incidence of adverse effects in hospitals is very high and a lot of them are related to medication. The most important factor in pharmaceutical interventions to reduce adverse effects is medication reconciliation, and this process is indispensable during hospital care. Reasons for reconciliation errors are numerous but high-rotation care unit, such as emergency department and short stay units (SSUs) are more hazardous areas for patient safety. Prospective observational study was performed for 3 months. Medication reconciliation and pharmacotherapeutic interventions were carried out. Indicators regarding coverage of the program, quality of prescription, and reconciliation were established and a financial analysis was done. A total of 843 patients were studied and pharmacotherapeutic intervention was carried out in 310 patients. A total of 2463 drugs were checked and 452 pharmacotherapeutic interventions were carried out. The most of these interventions belong to cardiovascular system. A total of 149 interventions were according to the pharmacotherapeutical hospital formulary and 303 were drug-related problems (DRPs). The most frequent cause of DRP was drug omission, followed by incomplete prescriptions. Of the DRP, 56.8% were reconciliation errors. The most common recommendation was starting treatment. An overall saving of $49,846.31 is estimated in this study according to the risk of an increased stay for DRP and the cost of avoidable stays. Patient's safety was increased by pharmacist's involvement on emergency department and SSUs. In SSUs, there are many polymedicated patients, so this is the most suitable place to involve the pharmacist. Pharmacist's interventions are equally accepted in both services.
