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Medication reconciliation in emergency departments

Calderón Hernanz B, Oliver Noguera A, Tomás Vecina S, Baena Parejo MI, García Peláez M, Juanes Borrego A, Calleja Hernández MA, Altimiras Ruiz J, Roqueta Egea F, Chánovas Borrás M

Grupo REDFASTER (SEFH), Spain. Hospital Son Llatzer. Mallorca, Spain. Programa SEMES-Seguridad del Paciente. Hospital Municipal de Badalona, Barcelona, Spain. Delegada de la Consejería Salud. Junta de Andalucía. Córdoba, Spain. Corporació Sanitaria Parc Taulí, Barcelona, Spain. Hospital Santa Creu i Sant Pau, Barcelona, Spain. Hospital Virgen de las Nieves, Granada, Spain. Fundació La Seu d’Urgell, Barcelona, Spain. Programa SEMES-Seguridad del Paciente, Función Althaia, Manresa, Barcelona, Spain. Programa SEMES-Seguridad del Paciente, Hospital Verge de la Cinta-Tortosa, Tarragona, Spain.

Medication errors, which are common in hospitals, lead to higher morbidity, mortality,
and expenditure. Errors are most common when patients are transferred from one level
of care to another, and the likelihood of mistakes is higher in emergency departments
because of the intrinsic nature of emergency care. The internationally recognized
remedy for this situation is medication reconciliation, defined as the process of obtaining
a complete, accurate list of the patient's prior medications and comparing it to the list of
medicines prescribed after admission to a new level of care. Discrepancies should be
considered and prescriptions changed if necessary. Both the person who will be
responsible for the next phase of care and the patient should be informed of the new list
of medications. This consensus statement offers a set of general recommendations for
medication reconciliation. Specific recommendations for each subgroup of medications
are also included to allow emergency department prescribing to be tailored to individual
patient characteristics. The recommendations in this statement should be overridden in
some cases if the risk-benefit ratio suggests that further individualization is required.
Individualized assessment of medications should be carried out by a multidisciplinary
team responsible for the patient’s care.

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