Resumen de Usefulness of a primary and specialized care prescription program for home treatment reconciliation at hospital admission
Ana María Alañón Pardo, Mª Luisa Moreno, Elida Vila Torres, Marta Rodríguez Martínez
Objective: To evaluate the reliability of a primary and specialized care prescription program (Fierabrás®) as source of information for the Pharmacotherapeutic History (PTH) of patients and its usefulness for Home Treatment Reconciliation (HTR).
Method: This prospective study included patients interviewed by the pharmacist for HTR at hospital admission (December 2013 - March 2014). The interview was guided by information from Fierabrás®, updated clinical records,and hospital outpatient dispensing programs. The resulting PTH (PTHInterview) was considered the true home treatment of patients. The reliability of the PTH inthe Fierabrás® program (PTHFierabrás®) was evaluated as the percentage agreement with the PTHInterview (% medications with same active ingredients and dosage regimens), and the discrepancy profile was analyzed.
Results: Interviews were conducted with 134 patients. The percentage agreement between PTHInterview and PTHFierabrás® was 68.7% (5.8 concurrences/patient), while full agreement between them was observed in only 17.9% of patients. Discrepancies were observed in 32.9% of the 1,182 medications recorded; 67.9% of these discrepancies were considered severe. The most frequent discrepancy (40.9%) was «Addition in Fierabrás®» (drugs recorded in Fierabrás® but not consumed by patients). 15.5% of medications were «high-alert» according to the Institute for Safe Medication Practices. Pharmacological groups with most discrepancies were: «Alimentary tract/Metabolism» (21.1%); «Cardiovascular system» (21.6%), and «Nervous system» (24.4%). High-alert drugs with the most discrepancies were insulins (48.5%), opioids (19.1%) and oral hypoglycaemic agents (16.2%).
Conclusions: The reliability of Fierabrás® was moderate, and the PTHFierabrás® was not in full agreement with the true home treatment of patients. It should complement rather than replace the pharmaceutical interview for HTR to improve the quality of the PTH obtained
