Efficacy of a reconciliation intervention by a specialized pharmacist to resolve medication-related problems of elderly patients admitted to an emergency department short-stay unit: a randomized clinical trial
Piqueras Romero C, Calderón Hernanz B, Segura Fragoso A, Juárez González R, Berrocal Javato MA, Calleja Hernández MA
Affiliation of the authors
Servicio de Farmacia, Hospital Nuestra Señora del Prado, Talavera de la Reina, Toledo, Spain. Grupo REDFASTER (SEFH), España, Servicio de Farmacia, Hospital Son Llatzer, Mallorca, Spain. Servicio de Investigación, Instituto de Ciencias de la Salud, Talavera de la Reina, Toledo, Spain. Servicio de Urgencias, Hospital Nuestra Señora del Prado, Talavera de la Reina, Toledo, Spain. Grupo REDFASTER (SEFH), Spain, Unidad de Gestión Clínica Provincial de Farmacia de Granada, Spain.
Piqueras Romero C, Calderón Hernanz B, Segura Fragoso A, Juárez González R, Berrocal Javato MA, Calleja Hernández MA. Efficacy of a reconciliation intervention by a specialized pharmacist to resolve medication-related problems of elderly patients admitted to an emergency department short-stay unit: a randomized clinical trial. Emergencias. 2015;27:364-70
To determine the effect on medication-related problems (MRPs) of a process of medication reconciliation carried out by a specialized pharmacist for patients aged 65 years or older admitted to an emergency department short-stay unit (SSU).
Methods.
Randomized clinical trial of 17 months (February 2013–June 2014) in the SSU of a hospital emergency department. Patients were aged 65 years or older at high risk of MRPs. A total of 130 patients were randomized to a control group (n = 65) or the intervention group (n = 65). The reconciliation process (intervention) was carried out
by a specialized pharmacist. The main outcome was the number of MRPs resolved in each group.
Results.
A total of 3081 medications for 130 patients were reviewed. The patients’ mean (SD) age was 79 (7.6) years and 66 (50.8%) were men. Discrepancies affecting 1901 medications (61.7%) were detected. The distributions of age, sex, and number of medication discrepancies were similar in the control and intervention groups. A total of 213 MRPs were detected; 110 (51.6%) were in the control group and 103 (48.4%) in the intervention group (P = .380).
Through the pharmacist’s reconciliation, significantly more of the MRPs were resolved in the intervention group (83.5%) than in the control group (26.4%) (P < .001).
Conclusions.
Medication reconciliation by a specialized pharmacist in the emergency department reduces MRPs for at-risk elderly patients in a SSU.
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