Medication reconciliation and review for older emergency patients requires improvement in Finland

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http://hdl.handle.net/10138/299659

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Schepel , L , Lehtonen , L , Airaksinen , M , Ojala , R , Ahonen , J & Lapatto-Reiniluoto , O 2018 , ' Medication reconciliation and review for older emergency patients requires improvement in Finland ' , International Journal of Risk and Safety in Medicine , vol. 30 , no. 1 , pp. 19-31 . https://doi.org/10.3233/JRS-180030

Title: Medication reconciliation and review for older emergency patients requires improvement in Finland
Author: Schepel, Lotta; Lehtonen, Lasse; Airaksinen, Marja; Ojala, Raimo; Ahonen, Jouni; Lapatto-Reiniluoto, Outi
Contributor: University of Helsinki, Divisions of Faculty of Pharmacy
University of Helsinki, University of Helsinki
University of Helsinki, Drug Research Program
University of Helsinki, Department of Diagnostics and Therapeutics
Date: 2018
Language: eng
Number of pages: 13
Belongs to series: International Journal of Risk and Safety in Medicine
ISSN: 0924-6479
URI: http://hdl.handle.net/10138/299659
Abstract: BACKGROUND: 10-30% of hospital stays by older patients are drug-related. The admission phase is important for identifying drug-related problems, but taking an incorrect medication history often leads to medication errors. OBJECTIVES: To enhance medication history recording and identify drug-related problems (DRPs) of older patients admitted to emergency departments (EDs). METHODS: DRPs were identified by pharmacists-led medication reconciliation and review procedures in two EDs in Finland; Helsinki University Hospital (HUS), and Kuopio University Hospital (KUH). One-hundred-and-fifty patients aged >= 65-years, living at home and using >= 6 medicines were studied. RESULTS: 100% of patients (N = 75) in HUS and 99% in KUH (N = 75), had discrepancies in their admission-medication chart recorded by the nurse or physician. Associations between admission-diagnosis and drug-related problems were found in 12 patients (16%) in HUS and 22 patients (29%) in KUH. Of these, high-alert medications (e.g. antithrombotics, cytostatics, opioids) were linked to eight patients (11%) in HUS and six patients (8%) in KUH. Other acute DRPs were identified in 19 patients (25%) in HUS and 54 patients (72%) in KUH. Furthermore, 67 patients (89%) in HUS and all patients in KUH had non-acute DRPs. CONCLUSIONS: Medication reconciliation and review at admission of older ED patients requires improvement in Finland.
Subject: Emergency department
medication reconciliation
medication review
drug-related problems
older patients
clinical pharmacy
high-alert medications
polypharmacy
RANDOMIZED-CONTROLLED-TRIAL
PHARMACIST
ERRORS
FREQUENCY
HISTORY
CARE
3142 Public health care science, environmental and occupational health
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