Design of a medication reconciliation program integrating hospital and primary care

• Autores: Miriam Heredia Benito, María Dolores Fraga Fuentes, Juan Carlos Valenzuela Gámez, Teresa Gómez LLuch, Elisa Zamora Ferrer, Patricia Nieto-Sandoval Martín de la Sierra
• Localización: European journal of clinical pharmacy: atención farmacéutica, ISSN 2385-409X, Vol. 18, Nº. 3, 2016, págs. 195-198
• Idioma: inglés
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• Resumen

  • Medication errors are common. Most studies focus on medication errors during a hospital stay. However, patient vulnerability is also present in the ambulatory care setting. The main objective was developing and implementing a medication reconciliation project assessing continuity of health care. It was performed a Standard Work Procedure and it was organized a multidisciplinary working team composed of one hospital pharmacist, primary care pharmacist and one geriatric physician. We designed the reconciliation project as a structured and a standardized process. The pharmacist selects patients using a risk stratification based on polymedication, and patient age in trauma unit. During hospitalization it is compared the patient’s pre-admission medication list with the patient’s current inpatient medication. Discrepancies are analysed and solved with specialists. When patient is discharged from hospital, we elaborate a report for primary physician. Moreover we provide the patient or family a medication schedule. Pharmacist phones the patient within 10 days to solve possible patient doubts and communicates with primary care physicians to discuss medication discrepancies. This project provides a simple methodology, at a low cost burden and easy to replicate. This is an innovative project due to the fact that it integrates primary care. Future research could assess the effects of the project on factors like minor number of discrepancies and medication errors, reduction on hospitalization rate or clinical impact