The application of compulsory conciliation in the settlement of disputes over Fukushima contaminated water discharge.

The imminent discharge of Fukushima-contaminated water into the ocean would result in severe controversies and disputes concerning marine environment pollution in Japan and the neighboring countries. This paper argues that high similarities can be found between the disputes arising from the imminent discharge and those subject to compulsory conciliation under the dispute settlement mechanism of the law of the sea. Together with the advantages of compulsory conciliation in settling disputes related to the exercise of discretion by states, it is asserted that compulsory conciliation could become the best choice to settle the potential disputes arising from the imminent discharge between Japan and the neighboring countries. This article also draws attention to some essential issues related to the application of compulsory conciliation, including the establishment of jurisdiction and authorities of the conciliation commission, and the implementation of the conciliation report.

Elección de pareja: Implicaciones y complicaciones / Mate Choice: Implications and Complications

Resumen La soledad individualista humana impele a vivir en pareja y a alcanzar complementariedad hombre/mujer, afecto y reci procidad. El periodismo científico de este artículo parafrasea el contenido de su bibliografía al revisar la elección de pareja, su satisfacción y complicaciones e instrucción preventiva de circunstancias que ocasionan ruptura. La falla -desde la elección-, desconoce los mecanismos entre razón e instinto sexual. El problema del amor no es ser amado sino desarrollar tal capacidad, pues lo extingue la inadaptación y monotonía. Se describe el acto elector/elegido y sus razones simultáneas: conscientes (homogeneidad/heterogeneidad del encuentro; emulación del modelo animal; tipo, dinámica vincular y redes sociales; aspectos sociodemográficos; ubicación geográfica y accesibilidad; compartición sexual y expectativas inmediatas/ futuras), e inconscientes (problemática electora, interacción diádica y antecedentes parentales; mecanismos de defensa, intercambio de disociaciones; idealización; reciprocidad negativa, lucha de poder, identificación proyectiva, búsqueda de aprecio por el otro; narcisismo, falso sí mismo, mecanis mos de dilación/evasión de responsabilidad, inseguridad, intrusión y colusión). Una pareja saludable, entiende/atiende la creación y mantenimiento del "nosotros", elimina la lucha de poder y produce conciliación permanente. El acuerdo y comprensión tolerante son indispensables para una relación emocional satisfactoria, estable y duradera.

Abstract Human individualistic loneliness impels us to live as a couple and achieve complementarity between man and woman, af fection, and reciprocity. The science journalism of this article reviews the choice of partner, their satisfaction and complications, and preventive instruction of circumstances that cause rupture. The failure from the election ignores the mechanisms between reason and sexual instinct. The problem of love is not to be loved but to develop such a capacity, for it is extinguished by maladjustment and monotony. The voting/elected act and its simultaneous reasons are described: Conscious (homogeneity/heterogeneity of the encounter; emulation of the animal model; type, dynamic link and social networks; Sociodemographic aspects; sexual sharing and immediate/future expectations). Unconscious (electoral problems, dyadic interaction, and parental background; defense mechanisms, exchange of dissociations; idealization; negative reciprocity, power struggle, projective identification, search for appreciation for the other; narcissism, false self, mecha nisms of procrastination/evasion of responsibility, insecurity, intrusion, and collusion). A healthy couple, understands/at tends to the creation and maintenance of the "we", eliminates the power struggle and produces permanent conciliation. Tolerant agreement and understanding are indispensable for a satisfying, stable, and lasting emotional relationship.

Pharmacist tracking and correction of medication errors: An improvement project in the observation ward of the emergency department.

OBJECTIVE: The risk of medication errors is high in emergency departments. Implementation of medication reconciliation activity complemented by pharmaceutical analysis of prescription is an effective way to reduce drug related problems. This study aimed to assess the potential clinical impact of these activities to prevent medication errors for the observation ward patients. The secondary objective was to assess these activities' cost-avoidance and benefit-to-cost ratio. MATERIAL AND METHODS: This study was conducted in a 16-bed unit, over a 5-month period. The patients' demographic and treatment details, and data from pharmaceutical activities were collected and analyzed by a pharmacist. Two pharmacists and an emergency physician assessed the potential clinical impact of medication errors. RESULTS: Medication reconciliation for 250 patients (15.7% of 1589 admitted patients) and pharmaceutical analysis of prescription for 302 patients (19%) were performed by the pharmacist. Medication reconciliation detected 752 errors in 197 patients; 19% were related to high-risk medications and 14% had a potential clinical impact assessed as major, critical or fatal. Pharmaceutical analysis of prescription revealed 159 drug related problems in 118 patients; of which 26% involved high-risk medications and 24% had a potential clinical impact assessed "at least major". In total, 16% of pharmacist interventions had a potential clinical impact assessed "at least major" in 33% of patients: this represents 1.8 pharmacist interventions formulated per day. CONCLUSION: The presence of a pharmacist in the observation ward of the emergency department is useful in detecting iatrogenic drug related problems and reducing their medical impact. The benefit-to-cost ratio is favorable for the hospital.

[Medication reconciliation on admission: One year of practice in health care institutions during the COVID-19 pandemic]. / Conciliation médicamenteuse à l'admission : bilan d'une année d'activité en établissement de santé durant la crise COVID-19.

OBJECTIVES: Medication reconciliation is a key point of the v2020 certification. The main objective of this study was to evaluate this activity over one year, including the first epidemic wave at COVID-19. The secondary objectives were to identify the obstacles and levers and to evaluate doctor satisfaction. METHODS: This was a retrospective study of drug reconciliations performed on admission during 12 months of the emergence of COVID-19. Patients aged 65 years and older from orthopedic and visceral surgery, acute hospitalization and conventional medicine units were included. Unintentional discrepancies were analyzed. The obstacles and levers were identified by means of a focus group. Doctors' satisfaction was collected using online quiz. RESULTS: A total of 760 patients were conciliated, of which 27% (n=208) by hospital pharmacy technicians. A decrease in activity was observed during the first epidemic wave. An unintentional discrepancy was found in 77% of patients, and only 48% were corrected by the prescriber. These results were impacted by the pandemic. The pharmaceutical team was mobilized in the logistical management of the crisis, but it was able to adapt in order to perpetuate the activity. Doctors are satisfied with the process. CONCLUSIONS: Medication reconciliation on admission is essential for the prevention of iatrogeny, particularly with the impact of the COVID-19 pandemic in healthcare institutions.

[Medication reconciliation and hospital-community transition securisation: Survey of community pharmacists]. / Conciliation médicamenteuse et sécurisation de la transition hôpital­ville : enquête auprès des pharmaciens d'officine.

OBJECTIVE: To collect the community pharmacists' perception on their role in the medication reconciliation's process. METHODS: We did an observational transverse study thanks to a survey of community pharmacists working in France, conducted in 2020. A digital questionnaire was submitted to Parisian community pharmacists before being shared on two Facebook groups. The responses were analysed with Microsoft Excel® software. We calculated percentages, used Chi2 or Fisher's exact tests and did qualitative analyses. RESULTS: We collected the perception of 135 community pharmacists, the majority was women (80%), relatively young (69.6% of 40 years old or less). They were 63.7% to claim knowing the medication reconciliation, but they could not define it properly. The subject's knowledge was statistically related to age (P-value<0.001) and previous contacts of the health care facilities (P-value<0.001). The majority of interviewed pharmacist considered the transmission of information to those health facilities as relevant and feasible and they expressed their willingness to get involved. However, they were limited by some obstacles such as the non-exhaustiveness of the medicinal record, the unsecured mail and the lack of feedbacks. CONCLUSIONS: Although the community pharmacists expressed interest for the medication reconciliation process and willingness to get involved, their role remained limited. Therefore, this process needs an improvement of its organisation and a generalisation of its practice to really benefit the hospital-community transition's safety.

[Targeting anticoagulated patients for medication reconciliation at discharge in orthopaedic surgery]. / Conciliation médicamenteuse de sortie ciblée en chirurgie orthopédique : focus sur les anticoagulants.

In orthopedic surgery, the well-known iatrogenic risk of oral anticoagulants is particularly increased due to surgical management (suspension and resumption of treatment). In order to prevent avoidable iatrogenic events linked to incomplete discharge documents, targeted medical reconciliation (MR) has been deployed. This is a single-center prospective study conducted in orthopaedic surgery for six months including any patient treated upon admission with an oral anticoagulant. The analysis of the compliance of discharge documents (hospitalization report and prescriptions) was carried out before and after pharmaceutical interventions. The criteria analysed included the mention of the oral treatment, its dosage as well as the supervision of the switch from heparin therapy to the usual oral treatment. The documents were compliant if the mention of oral anticoagulant treatment and the date of the shift were correctly documented. Thirty-seven patients were included. The compliance rate of discharge documents was significantly improved by MR, going from 13.5 % to 78.4 % (P <0.05). The non-compliances before the intervention concerned the absence of mention of: the usual treatment (64.9 %), its dosage (81.1 %) or the switch's securing (75.7 %). Discharge from surgery of the patient on anticoagulants is a stage presenting a real risk which can be managed by the intervention of pharmacists. Improving the compliance of discharge documents is a first step towards better securing drug management.

[Medication reconciliation, an innovative partnership]. / La conciliation médicamenteuse, un partenariat innovant.

An innovative partnership between advanced practice nurses (APN) in psychiatry and mental health, the pharmacy department of a public health institution and the various health care professionals in the city. It allows the APN to establish itself in a secure manner and to take ownership of drug prescription. It is at the service of users in order to improve the safety and quality of care and to optimise their quality of life with a care proposal adapted to their needs.

[From medication reconciliation to shared medication review: Pilot study integrating support for community pharmacists within a pharmaceutical care pathway]. / De la conciliation médicamenteuse au bilan partagé de médication : étude pilote intégrant un accompagnement des pharmaciens d'officine au sein d'un parcours de soins pharmaceutiques.

INTRODUCTION: Medication reconciliation at hospital and the shared medication review are two complementary activities for securing the medication management of the elderly patient. We are experimenting with a pharmaceutical care pathway including a support approach to promote continuity between these two activities and the initiation of shared medication review. MATERIALS AND METHODS: An admission and discharge medication reconciliation has been set up in a geriatric follow-up care and rehabilitation service. A drug assessment was also carried out during the hospital stay. Support for community pharmacists following conciliation was provided by phone calls. Medication discrepancies at admission and discharge, pharmaceutical interventions (PI) as well as satisfaction and difficulties encountered by community pharmacists were collected. RESULTS: Thirty-three patients were included in the study. On admission, 33% of patients had an unintentional discrepancy and 15% on discharge. On average 1.15 PI per patient were notified. The support was propounded to 13 pharmacists. Eight pharmacists (62%) accepted it. Among them, 5 (62.5%) had never performed a medication review. Lack of time was the main difficulty encountered by pharmacists. DISCUSSION AND CONCLUSION: Our pathway enables to integrate hospital and primary care activities and specifically support the delicate transition between them. This enables to facilitate the implementation of these activities and to maintain a relevant and secure continuity of pharmaceutical care.

[Continuity of medication after hospitalisation in geriatric follow-up and rehabilitation care]. / Continuité médicamenteuse après une hospitalisation en soins de suite et de réadaptation gériatrique.

After one year of practice, the medication reconciliation approach in follow-up and rehabilitation care was evaluated. The aim of the activity was to identify changes in treatment (CT). Three hundred and two patients benefited from the process. Some 82.2% of drug lines had voluntary TCs at discharge and all of patients had at least one TC at discharge. What are the consequences of so many TCs and what are the levers to limit these effects?

[Observational study of factors predictive of medication errors and of prioritization criteria in geriatric medication reconciliation]. / Étude observationnelle de facteurs prédictifs d'erreurs médicamenteuses et de critères de priorisation en conciliation médicamenteuse gériatrique.

OBJECTIVES: The geriatric population, often polymedicated, is exposed to the risk of adverse drug events. Medication reconciliation (MR), which is an interactive and pluriprofessional process, helps ensure continuity of care. The objective of this study was to analyze and to define relevant prioritization criteria for MR in older patients in order to avoid a maximum of medication errors. METHODS: A clinical audit of MR at the transition points of patient admission and discharge was conducted prospectively for 10 months. Patients were selected on the basis of a prioritization procedure already established in our structure, that is the presence of at least one of the three following criteria: originating from an hospital department, severe renal failure and prescription of at-risk drugs. RESULTS: The cohort of patients reconciled at admission included 136 patients. A total of 63 unintentional discrepancies (UDs) were identified, the majority of which (76.2%) involved drug omissions. Three criteria were identified as independent predictors of UDs risk on the entry prescription compared to the optimized drug assessment: rheumatological history, originating from an hospital department and hyponatremia. Hyponatremia was found in the present study to be the most relevant criterion that significantly increased the risk of having an UD on the patient's prescription, particularly a risk of treatment omission at admission. CONCLUSION: This study will allow to improve the prioritization criteria on the healthcare establishment's procedure and to implement MR in geriatric day hospitalization in order to strengthen the city-hospital link.

[Pharmaceutical cares as means of prevention against drug iatrogenic: Case of oral anticoagulant]. / Les soins pharmaceutiques comme moyen de prévention contre les risques iatrogènes des médicaments : cas des anticoagulants oraux.

Oral anticoagulant can have a significant risk of adverse events, particularly when it is initiated, modified or interrupted. Pharmaceutical care through medication reconciliation could improve the benefit-to-risk ratio of these drugs. A prospective and interventional single center study was conducted from March through August 2018 in medicine and surgical units. Patients with an oral anticoagulant prescribed and coming from outpatient sector were included. These patients received a medication reconciliation at admission and discharge. Frequency and type of discrepancies were studied. Their gravity rating was assessed using the Cornish et al. scale. This study included 162 patients. The medication reconciliation at the admission allowed the detection of 133 unintentional discrepancies which 16 of them represented a high risk for the patient included nine errors about oral anticoagulant prescribing. Concerning the reconciliation at discharge, 51 unintentional discrepancies had been detected: 12 of them represented a high risk for the patient included eight errors about oral anticoagulant prescription. The acceptance rate of the discrepancies was 86% and reflected discrepancies severity. This result reached 96.4% if we took into account discrepancies with a severe clinical impact. This study highlighted oral anticoagulant represented relevant prioritization criteria to the long-lasting implementation of pharmaceutical care. This secures the management of the patient since the admission until the hospital discharge. The last step of our approach would be to study the needs about data transmission to the community caregivers.

[Quality of life at work in Quebec, between realities and challenges]. / Qualité de vie au travail au Québec, entre réalités et défis.

Quality of life at work (QWL) is an issue of great importance, particularly in the health sector. In Quebec, organizations attach particular importance to this issue, which is reflected in specific human resources practices. This has led to some changes in terms of expectations, but also in terms of effects and issues, particularly with regard to the employer-employee relationship.

Survey data on the consequences of COVID-19 and home confinement on the educational community and families in Spain.

This paper presents a dataset concerning the consequences of the COVID-19 pandemic and home confinement on the educational community and families, and the possibilities and opportunities for the return to schools. Data were collected through an online based cross-sectional survey between June 29, 2020 and July 12, 2020 in Spain. A total of 7,305 people who had children in their care during the COVID-19 crisis and the home-confinement period responded to the survey. The survey contained items concerning (i) socio-demographic information, (ii) conciliation of work, personal and family life during confinement, (iii) the impact of the pandemic on the respondent's family, and (iv) the respondents' opinion on their child(ren)'s return to school. Data were analysed using Stata (version 14) and are represented as frequencies and percentages based on responses to the entire survey. Researchers can use the dataset to analyse how home confinement impacted people with children in their care. Additionally, government authorities and education policymakers can use the data to ensure that schools respond to parents' main concerns in a pandemic context, as well as to be prepared to implement appropriate protocols in possible future similar crisis.

Employee Engagement and Wellbeing in Times of COVID-19: A Proposal of the 5Cs Model.

The COVID-19 pandemic has had an unprecedented impact on the labor market. The psychological pressure and uncertainty caused by the current changing workplace environment have led to negative consequences for workers. Considering the predictive relationship between employee engagement and wellbeing and in light of this unprecedented situation that affects workers of all the industries worldwide, this study aims to identify the key main drivers of employee engagement that can lead to employee wellbeing in the current context. Through a literature review, a theoretical model to strengthen engagement in times of COVID-19 is proposed. The main factors are conciliation, cultivation, confidence, compensation, and communication. Whereas prior to the pandemic, firms had already understood the need to achieve this, it is now considered a vital tool for staff health and wellbeing. This article makes two main contributions. First, it provides a model for boosting employee engagement, and therefore, wellbeing. Second, managerial suggestions are made to apply the theoretical model.

[Medical reconciliation for hospitalized patients in orthopedic surgery department: Return of experience over 2 years of practice]. / Conciliation médicamenteuse à l'entrée des patients dans une unité de chirurgie orthopédique : retour d'expérience sur plus de 2 ans de pratique.

OBJECTIVES: Some medication errors can be prevented by pharmacist action such as medication reconciliation. The main objective of this study was to evaluate the medication reconciliation activity after two years of practice. The secondary objective was to assess the medical staff's satisfaction following the setting up of the activity. METHODS: This retrospective study was realized over a period of two years in our hospital. Patients meeting the following criteria were included: 65 years and over, hospitalized in orthopedic surgery department, preferentially after a discharge of the emergency room. After the best possible medication history was established, it is compared to medicines ordered. The discrepancies were defined as intended or unintended. Study data were collected and analyzed using Excel and SPSS statistics®. RESULTS: A total of 899 patients met the inclusion criteria during the study period, mean age was 78 years (27; 104). A total of 84 % of our cohort was admitted after a discharge of the emergency room. Seventy five percent of the population had at least an unintended discrepancie, a mean of 2,3 unintended discrepancies per patient was identified. Seventy five percent of the unintended discrepancy were discussed and resolved. The medical staff was mostly satisfied of the activity. CONCLUSION: The medication reconciliation secured the drug management of hospitalized patients.

[Continuity of medication management after hospitalization in geriatric subacute rehabilitation care]. / La continuité médicamenteuse après une hospitalisation en soins de suite et de réadaptation gériatrique.

After one year of practice, a medication reconciliation process in geriatric aftercare was evaluated. The objective of the activity was to identify treatment changes (TC). 302 patients benefited from approach, 82.2% of changes was voluntary at hospitalization discharge and 100% of patients benefited from at least one change at hospitalization discharge. What are the consequences of so many changes and what are the measures to limit these consequences?

Dupla carreira esporte-educação: a realidade dos atletas da elite dos saltos ornamentais brasileiros / Sports-education dual career: the reality of elite fancy diving athletes in Brazil / Doble carrera deporte-educación: la realidad de los deportistas brasileños de élite en saltos ornamentales

Resumo O objetivo do presente estudo foi apresentar e analisar o perfil educacional e esportivo dos atletas de saltos ornamentais que participaram do Troféu Brasil de 2018, mediante utilizaão de um questionário estruturado com base na perspectiva de formação holística para a dupla carreira. Com amostra definida em 15 participantes, a análise exploratória foi conduzida por meio de estatística descritiva no SPSS mediante frequência geral e específica. Os resultados sugerem a compatibilidade entre as formações esportiva e educacional em uma perspectiva denominada trajetórias de transição fluidas, observando-se casos de descontinuação na formação superior. Ressalta-se a carência de uma legislação nacional sobre dupla carreira e de políticas institucionais que promovam o acesso, a permanência e a finalização da formação acadêmica dos atletas de alto rendimento, bem como aponta-se a necessidade de novos estudos com diferentes modalidades a fim de que se aprofunde o debate sobre a dupla carreira esportiva.

Abstract This study aims to present and analyze the sporting and educational profile of fancy diving athletes who participated in the 2018 Brazil Tournament (Troféu Brasil). It uses a questionnaire based on the holistic training model for a dual career. Exploratory analysis was conducted with a sample of 15 individuals, using descriptive statistics on the Statistical Package for the Social Sciences (SPSS) software according to general and specific frequency. The results suggest that sporting and educational training are compatible under a perspective called fluid transition pathways, with cases of higher education discontinuation. The study underscores the lack of legislation on dual careers in Brazil as well as institutional policies that promote access, continuation and completion of academic education for high-performance athletes. Moreover, it points out the need for new studies to expand the debate on dual careers in sports.

Resumen El objetivo de este estudio fue presentar y analizar el perfil, educacional y deportivo, de los atletas de saltos ornamentales que participaron en el Trofeo Brasil de 2018, utilizando un cuestionario estructurado basado en la perspectiva de la formación holística para el doble grado universitario. Con una muestra definida en 15 participantes, el análisis exploratorio fue conducido a través de estadística descriptiva en el software Statistical Package for the Social Sciences (SPSS) mediante frecuencia general y específica. Los resultados sugieren la compatibilidad entre las formaciones deportiva y educativa en una perspectiva denominada trayectorias de transición fluidas y se observaron casos de discontinuidad en la educación superior. Se destaca la falta de una legislación nacional sobre el doble grado y de políticas institucionales que promuevan el acceso, permanencia y finalización de la formación académica de los atletas de alto rendimiento, así como la necesidad de que se realicen nuevos estudios con diferentes modalidades para que se profundice el debate sobre el doble grado deportivo.

Litigations following spinal neurosurgery in France: "out-of-court system," therapeutic hazard, and welfare state.

OBJECTIVE: Spinal surgeries carry risks of malpractice litigation due to the random nature of their functional results, which may not meet patient expectations, and the hazards associated with these complex procedures. Claims are frequent and costly. In France, since 2002, a new law, the Patients' Rights Law of March 4, 2002, has created an alternative, out-of-court scheme, which established a simplified, rapid, free-of-charge procedure (Commission for Conciliation and Compensation [CCI]). Moreover, this law has optimized the compensation provided to patients for therapeutic hazards by use of a national solidarity fund. The authors analyzed the consequences of this alternative route in the case of claims against private neurosurgeons in France. METHODS: From the data bank of the insurer Mutuelle d'Assurances du Corps de Santé Français (MACSF), the main insurance company for private neurosurgeons in France, the authors retrospectively analyzed 193 files covering the period 2015-2019. These computerized files comprised the anonymized medical records of the patients, the reports of the independent experts, and the final judgments of the CCI and the entities supporting the compensation, if any. RESULTS: During the 5-year study period (2015-2019), the insurance company recorded 494 complaints involving private neurosurgeons for spinal surgery procedures, of which 126 (25.5%) were in civil court, 123 (24.9%) were under amicable procedure, and 245 (49.6%) were in the out-of-court scheme administered by the CCI. Out of these 245 cases, only 193 were closed due to delays. The conclusions of the commission were rejection/incompetence decisions in 47.2% of the cases, therapeutic hazards in 21.2%, nosocomial infections in 17.6%, and practitioner fault in 13.5%. National solidarity compensated for 48 complaints (24.8%). The final decision of the CCI is not always consistent with the conclusions of the experts mandated by it, illustrating the difficulty in defining the concept of hazards. The authors found that the therapeutic hazards retained and compensated by the national solidarity included decompensated spondylotic myelopathies (15% of the 40 cases) and cauda equina syndromes (30%). As allowed by law, 11.5% of the patients who were not satisfied triggered a classical procedure in a court. CONCLUSIONS: In the French out-of-court system, trial decisions resulting in rulings of proven medical malpractice are rare, but patients can start a new procedure in the classical courts. The therapeutic hazard remains a subtle definition, which may be problematic and require further discussion between experts and magistrates. In spite of the imperfections, this out-of-court system proposes a major evolution to move patients and medical providers from legal battles to reconciliations.

Quality of Working Life, Psychosocial Factors, Burnout Syndrome and Emotional Intelligence.

The objective of this work is to study the quality of working life associated to psychosocial factors and risks, burnout syndrome and emotional intelligence, as well as being able to detect predictors of the said syndrome. The sample consisted of 311 professionals working in direct contact with an intellectual disability from 15 associations of Extremadura (Spain). The Spanish version of the CESQT questionnaire was administered to evaluate burnout syndrome, the Wong & Law Emotional Intelligence Scale (WLEIS) was used to evaluate emotional intelligence, while the UNIPSICO Battery was used to evaluate the psychosocial factors of demands (work-family conflict and psychosomatic problems) and resources, such as social support and work satisfaction. The results indicate average values of burnout, revealing that work satisfaction, emotional intelligence, and social support are related to burnout syndrome. In addition, there are also positive correlations between psychosomatic symptoms and work-family conflict. Satisfaction at work, social support, and emotional intelligence (intrapersonal and interpersonal perception, use and regulation of emotions) predict burnout syndrome. What is more, the psychosomatic symptoms and work-family conflict explain, respectively, 17% and 17.9% of their variance. Thus, there is a need to develop intervention programs that encourage social support and the conciliation of family life, as well as training skills related to emotional intelligence, such as communication and conflict resolution.

[Is the medication reconciliation achievable and relevant in Psychiatry?: Feedback on the implementation of medication reconciliation on hospital admission]. / La conciliation médicamenteuse est-elle réalisable et pertinente en Psychiatrie ? : Retour d'expérience sur la mise en place de la conciliation à l'admission.

OBJECTIVE: The health care pathway of patients suffering from mental disorders is complex and includes a risk of interruption of treatment. We implemented medication reconciliation at patients' admission to mental health care service in February 2017. The aim of this study was to achieve a feedback experience answering our questions about the feasibility and relevance of this process. METHOD: A prospective analysis of medication reconciliations over the first 7 months of implementation was carried out according to 3 activity indicators and 6 performance indicators. RESULTS: A total of 39 patients were reconciled and 56.4 % of them were in enforced hospitalization unit. All patients were interviewed by the pharmacist. Collected information during this interview was concordant with at least one of the other sources in 70.4 % of the cases. Thirteen patients were not reconciled within 72h after their admission because of their psychiatric pathology. The average number of unintentional medication discrepancy (UMD) detected was 0.97 per reconciled patient. The rate of major gravity UMD was 23.7 %. The number of UMDs per patient was significantly higher in enforced hospitalization unit (P<0.05). UMDs were essentially related to somatic drugs (81.6 %). Nearly 95 % of the detected UMDs resulted in a modification of prescription. CONCLUSION: These results show that medication reconciliation at patients' admission is feasible and relevant in psychiatry. To limit constraints related to psychiatric pathology, we propose to perform medication reconciliation of patients more than 72 hours after patient admission provided that their clinical condition allows it.