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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:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Emergency patients with medication reconciliation | All patients who beneficiated from medication reconciliation in the emergency department between November 2017 and April 2018 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Medication reconciliation | Other | No intervention was performed other than collecting data on patients' medical files |
|
| Measure | Description | Time Frame |
|---|---|---|
| Variables influencing the number of UMD in the emergency department | Variation of the number of UMD for each variable was measured to identify the impact of each factor on medication errors (linear regression). Variables measured were the variables described in the protocol section. | Nov2017-Apr2018 |
| Measure | Description | Time Frame |
|---|---|---|
| Number and type of UMD | Nov2017-Apr2018 | |
| Correction rate of UMD | Nov2017-Apr2018 | |
| Impact of organizational variables on the number of UMD |
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Inclusion Criteria:
Exclusion Criteria:
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All patients who beneficiated from medication reconciliation in the emergency department between November 2017 and April 2018
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| Name | Affiliation | Role |
|---|---|---|
| Jennifer Corny, PharmD | Pharmacy Department | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Groupe Hospitalier Paris Saint Joseph | Paris | Île-de-France Region | 75014 | France |
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| ID | Term |
|---|---|
| D004630 | Emergencies |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D059065 | Medication Reconciliation |
| ID | Term |
|---|---|
| D008508 | Medication Errors |
| D004358 | Drug Therapy |
| D013812 | Therapeutics |
| D019300 | Medical Errors |
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| Nov2017-Apr2018 |
| D006296 |
| Health Services |
| D005159 | Health Care Facilities Workforce and Services |
| D008509 | Medication Systems |
| D009934 | Organization and Administration |
| D006298 | Health Services Administration |
| D010346 | Patient Care Management |