4CPS-024 Implementation of a patient stratification method to prioritise medication reconciliation at admission in the emergency department
Year: 2025
Type: conference-paper
Abstract: Background and Importance Medication reconciliation (MR) in the Emergency Service (ES) involves creating a complete list of a patient’s prior medications, comparing it to the current prescription, and resolving any discrepancies. REDFASTER group found that 79% of patients show medication discrepancies. Implementing a patient stratification system is essential to prioritise MR. Aim and Objectives To implement a patient stratification method to prioritise MR performed by the pharmacist at admission for patients in ES. To prioritise MR conducted by the pharmacist for target patients receiving high-risk medications (HRM). Material and Methods A stratification tool was created to prioritise MR for high-risk patients in the ES, using Microsoft Forms, scoring variables. Phases Form design (12/2023–01/2024). Inclusion of variables in the form: Age: ≥75 years (2 points), 65–74 years (1 point), <65 years (0 points). Chronic treatment (CT), categorised by drug groups: Oral cytostatics, immunosuppressants, antiretrovirals, hospital-dispensed medications (5 points). Alpha-adrenergic agonists, oral anticoagulants, antiplatelets, antidepressants, anti-Parkinsonians, antiepileptics, antipsychotics, benzodiazepines, beta blockers, amiodarone/dronedarone or digoxin, corticosteroids >3 months, opioids or non-steroidal anti-inflammatory drugs, diuretics, ocular and respiratory therapy (1 point). stratification levels: N1: Patients with 2 points for age and ≥5 points for CT. N2: Patients with ≥5 points for CT. N3: Patients with <5 points for CT. The pharmacotherapy history of N1 patients is collected, and discrepancies are identified. Discrepancies are communicated and resolved with the responsible physician. Implementation After the form was developed, emergency pharmacists began performing patient stratification. To evaluate the activity over 10 days, RE were recorded across the three stratification levels. Results Se estratificaron 612 pacientes en total, con un promedio de 18,54 pacientes por día. La media de pacientes diarios por nivel de estratificación fue: N1 (2,84), N2 (1,48) y N3 (14,21). La distribución fue: N1: 15,36% (n=94). N2: 8,01% (n=49). N3: 76,63% (n=469). En total se produjeron 39 errores de ER en 83 pacientes. El número medio de errores por paciente en cada grupo fue: N1: 1,23 errores/paciente. N2: 0,50 errores/paciente. N3: 0,31 errores/paciente. La principal causa de error en todos los grupos fue la omisión. Conclusion and Relevance This method effectively streamlines medication reconciliation (MR) and is easily implementable for Pharmacy Services with electronic chronic medication records and an emergency department pharmacist. References and/or Acknowledgements REDFASTER Conciliación de los medicamentos en los servicios de urgencias SEFH, España. 2013;25:204–217. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://gruposdetrabajo.sefh.es/redfaster/documentos/conciliacion-de-los-medicamentos-en-los-servicios-de-urgencias_articulo.pdf Conflict of Interest No conflict of interest
Authors: J Fernández Vela, A Lázaro Cebas, IJ Tamboleo Sánchez, E Sevilla Alarcón, Á Varea Sánchez, ME Martínez Madrid
Institution: Santa Lucía University General Hospital
Language: English
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4408376092