Medication reconciliation Not Applicable
Conditions
Interventions
One group of patients will be included in a MedRec programme (intervention group) and the other used for comparison/control. A team made up of pharmacists, blinded to the assignation and intervention,
there will be two exactly similar copies which will be guarded under lock and key by the emergency coordinator. Another team of pharmacists blinded to the patients? assignation and each intervention a
Sponsors
National University of Colombia (Universidad Nacional de Colombia) (Colombia)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Adults (aged 18 or over) 2. Patients admitted and assessed as triage I and II 3. Prescribed at least one prescription medication before admission 4. To be hospitalized for at least 24 hours 5. Only patients with a time admission income less than 24 hours and 6. Had signed study participation agreement and completion of informed consent form
Exclusion criteria
Exclusion criteria: 1. They are scheduled for discharge on the same day 2. They are not able to answer the questions needed to complete the study 3. They are unable to communicate due to language difficulties, were under psychiatric care, medical record documentation of dementia or confusion and/or are unable to give consent. If a patient had more than one admission during the study period, only the first admission will be evaluated
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Medication discrepancies associated with the intervention. The following definition of medication discrepancy has been adopted for the present study: ?Any patient medication-related statement regarding medication consumed at home, made during admission to the emergency service.? Discrepancies will be prospectively identified. The main result will lie in identifying patients having at least one discrepancy regarding the medication being taken at home, then recording it and communicating it. Medication discrepancies may be associated with drugs, medication brand-name, dose, duration, frequency, formulation, administration route, resumption of appropriate medication, illegible medical orders/prescriptions. Identifying the type of discrepancy: Detecting the presence of some of the following events: 1.1. Omission (not ordering medication which a patient has been taking before admission) 1.2. Therapeutic duplicity (receiving more than one similar medication for the same indication) 1.3. Slowness in resuming therapy (selecting one of the following categories: before 6 hours, 6-12 hours, 12-24 hours or more than 24 hours after being admitted) 1.4. Therapy instituted too soon (i.e. treatment being reinitiated without taking frequency of taking a prescribed drug at home into account: before 6 hours, 6-12 hours, 12-24 hours or more than 24 hours) 2. Prescription discrepancies 2.1. Inconsistency or omission of some type of the following information: medication brand-name, dose, frequency, administration route or illegible orders 2.2. Prescription omission (when a patient has been given medication which has not been prescribed) 2.3. Medications lacking indication (medication administered without any indication, not associated with a diagnosis or consuming unneeded medication) 2.4. Allergies and interactions (these should be classified according to the following categories: higher (interaction could affect a patient?s life or cause permanent damage must be suspended immedia | — |
Secondary
| Measure | Time frame |
|---|---|
| Classifying and evaluating discrepancy safety: Involuntary medication discrepancies which may cause damage are defined as, ?An incident potentially leading to a medication-related lesion.? The potential to cause damage has been used to measure medication safety and its reduction as an action to reduce real medical administration records (RAM). Discrepancy risk has been defined in three classes (according to Cornish et al.): 1. Class 1 (those probably not causing clinical deterioration or nuisance) 2. Class 2 (those having the potential to cause moderate nuisance or clinical deterioration) 3. Class 3 (those having the potential to cause serious discomfort for a patient or significant clinical deterioration) Characterising the population seeking help from emergency services will involve recording date regarding chronological age in years, gender, socioeconomic strata, number of prior hospitalisations, number of morbidities, type of co-morbidity, how many medications are being taken, the type of medication and interventions made by the pharmacist. Characterizing and evaluating reconciliation will involve evaluating the opportunity and suitability of pharmaceutical action. The number of interventions made by a pharmacist will be measured, as will the medication history?s level of acceptance and average time spent on MedRec in hours. | — |
Countries
Colombia
Outcome results
None listed