Medication list assessment in Spanish hospital emergency departments.

BACKGROUND: Medication errors lead to morbidity and mortality among emergency department (ED) patients. An inaccurate medication history is one of the underlying causes of these errors. OBJECTIVES: This study was performed to determine the prevalence of patients with discrepancies between the medical list information contained in the clinical history compiled on admission to the ED and the list of medications patients are actually taking, to characterize the discrepancies found, and to analyze whether certain factors are associated with the risk of discrepancies. METHODS: We conducted a cross-sectional, descriptive, observational, multicenter study with an analytic component in the EDs of 11 hospitals in Spain. We compared pharmacist-obtained medication lists (PML) with ED-obtained medication lists (EDML). Discrepancy was defined as one or more differences (in drug or dosage or route of administration) between the EDML and PML. The endpoints were the proportion of patients with discrepancies in their home medical lists, and the prevalence of certain factors among patients with discrepancies and those without. RESULTS: We detected 1476 discrepancies in 387 patients; no discrepancies were found in 20.7%. The most frequent discrepancies involved incomplete information (44.2%) and omission (41.8%). In the bivariate analysis, age, number of medications, and Charlson comorbidity score were significantly associated with discrepancy. In the multivariate analysis, number of medications and hospital were the variables associated with discrepancy. CONCLUSIONS: The EDML differed from the list of medications patients were actually taking in 79.3% of cases. Incomplete information and omission were the most frequent discrepancies. Age, number of medications, and comorbidities were related to the risk of discrepancies.

Programa de intervención farmacéutica en el servicio de urgencias para mejorar la seguridad del paciente / Pharmacist intervention program to improve patient safety in an emergency department

Objetivos: Evaluar el resultado de la implantación de un programa de atención farmacéutica en un servicio de urgencias (SU) mediante el análisis de las intervenciones farmacéuticas realizadas, y la identificación de los problemas relacionados con los medicamentos (PRM) en el servicio. Método: Incorporación de un farmacéutico a tiempo parcial en el SU durante un periodo de 7 semanas desde febrero 2009. Se incluyeron pacientes de las áreas de boxes, observación y/o críticos del SU que cumplían algún factor de riesgo relacionado con el paciente o con su medicación y/o que tuvieran una alta probabilidad de ingreso. Las variables registradas fueron: datos demográficos, datos clínicos de interés, antecedentes patológicos, medicación habitual, motivo de consulta y medicación prescrita en el SU. Se registraron y clasificaron las intervenciones farmacéuticas asociadas a un PRM, las recomendaciones de terapia secuencial, así como las reacciones adversas a medicamentos(RAM) como motivo de consulta al SU. Resultados: Se incluyeron 90 pacientes (63,7% mujeres), con edad media de 79,3(± 10,6) años. Se registraron 131 intervenciones en 62 (68,9%) pacientes: 120 (91,6%) asociadas a un PRM, de las cuales la intervención mayoritaria 54 (45%) fue iniciar un tratamiento, seguido de la suspensión de un medicamento en 28 (23,3%) casos. Según la clasificación de los PRM, el 53,3% se consideraron de necesidad, en un 15% de efectividad y en un 31,7% de seguridad. Destaca la presencia de polimedicación ( 5 fármacos) como factor de riesgo que requiere intervención farmacéutica en los pacientes incluidos (p = 0,008). La presencia de 2 o más factores de riesgo se mostró como una variable asociada a la aparición de un PRM (p = 0,003). Respecto a la valoración de los medicamentos agrupados por actividad farmacológica, la mayoría de la (..) (AU)

Objective: To assess the implementation of a pharmacist intervention program with in an emergency department, including the analysis of interventions by the pharmacist and identification of medication problems in the department. Methods: A pharmacist was employed part-time in the emergency department for 7 weeks starting in February 2009.Patients with a patient-related or drug-related risk factor or who were likely to be admitted to hospital were included from the areas of the emergency department’s cubicles, observation unit, and/or critical case section. The variables recorded were demographic characteristics, clinical data of interest, medical history, medications currently used, reasons for seeking care, and drugs prescribed in the emergency department. Pharmacist interventions related to a medication problem were recorded and classified. Other information gathered included the sequence of therapeutic recommendations and adverse drug interactions as a reason for seeking emergency care. Results: Ninety patients (63.7% women) with a mean (SD) age of 79.3 (10.6) years were studied. One hundred thirty one interventions were recorded for 62 (68.9%) patients. One hundred twenty of these (91.6%) involved a medication problem. Initiating a treatment was the most frequent decision (in 54 [45%] patients); in 28 cases (23.3%) a medication was with drawn. Regarding types of medication problems detected, 53% were (..) (AU)

Cura con plasma de úlceras tórpidas / No disponible

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