Evaluation of medical reconciliation during hospital admission of renais patients
DOI:
https://doi.org/10.48017/dj.v9i3.2583Keywords:
Patient safety, medication erros, nephrologyAbstract
Objective: To assess the medication reconciliation process during admission to the nephrology infirmary of the Hospital das Clínicas of the Federal University of Pernambuco. Methodology: Retrospective and descriptive quantitative study, made possible through the analysis of forms applied by clinical pharmacists during their work routine. The drugs most involved in discrepancies were identified, their association with polypharmacy and service performance analysis. The collected data are presented as frequency, average and standard deviation. The statistical analysis was performed using SPSS.V.21.0, the Qui square test was used to analyze the association between the dichotomous variables and the level of rejection of the null hypothesis was fixed at 1% (p< 0.01). Results: Foram analyzed 250 forms. 63.2% presented discrepancies, while 32.3% were unintentional discrepancies. 1,384 medications were used by patients before hospitalization, among which 24.1% had some type of discrepancy. Furosemide and Metformin are frequently associated with intentional discrepancies; Anlodipine for undocumented intentional discrepancy and vitamin D/Calcitriol for unintentional discrepancy. An association was verified between polypharmacy and the occurrence of discrepancies (p<0.01). Conclusion: A low prevalence of unintentional discrepancies was identified, therefore greater attention should be given to drugs that require laboratory monitoring. Furthermore, a statistical association between polypharmacy and the occurrence of discrepancies was observed. The reconciliations are mostly carried out in a maximum interval of 48 hours and present a variable monthly coverage.
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References
Al Hamarneh, Y. N., Tsuyuki, R. T., Jones, C. A., Manns, B., Tonelli, M., Scott-Douglass, N., ... & Hemmelgarn, B. R. (2018). Effectiveness of pharmacist interventions on cardiovascular risk in patients with CKD: a subgroup analysis of the randomized controlled RxEACH Trial. American Journal of Kidney Diseases, 71(1), 42-51.
Alqenae, F. A., Steinke, D., & Keers, R. N. (2020). Prevalence and Nature of Medication Errors and Medication-Related Harm Following Discharge from Hospital to Community Settings: A Sys-tematic Review. Drug safety, 43(6), 517–537. https://doi.org/10.1007/s40264-020-00918-3
Araujo, E., Viapiana, M., Domingues, E., Oliveira, G., & Polisel, C. (2017). Intervenções farmacêuti-cas em uma unidade de terapia intensiva de um hospital universitário. Revista Brasileira de Farmácia Hospitalar e Serviços de Saúde, 08(3). https://doi.org/10.30968/rbfhss.2017.083.005
Barboza da Silva, T., Pegoraro Alves-Zarpelon, S., & Laureano, J. V. (2021). Conciliação medicamen-tosa em uma unidade de internação de hospital público do sul do brasil. Infarma - Ciências Farmacêuticas, 33(2), 158. https://doi.org/10.14450/2318-9312.v33.e2.a2021.pp158-166
Belda-Rustarazo, S., Cantero-Hinojosa, J., Salmeron-García, A., González-García, L., Cabeza-Barrera, J., & Galvez, J. (2015). Medication reconciliation at admission and discharge: An analysis of prevalence and associated risk factors. International Journal of Clinical Practice, 69(11), 1268–1274. https://doi.org/10.1111/ijcp.12701
Bezerra, C. S. L. F., Almeida, F. H. O. d., Santos, A. N. d., Sousa, D. S. d., Santos, I. V., Santos, A. R., Silva, W. B. d., & Silva, F. A. d. (2021). Análise de discrepância nas prescrições dos pacientes admitidos no centro cirúrgico de um hospital público de urgência. Research, Society and De-velopment, 10(17), Artigo e146101724205. https://doi.org/10.33448/rsd-v10i17.24205
Chandrasekhar, D., Ganesan, V. M., Sreekumar, S., Pradeep, A., Geoji, A. S., & George, A. E. (2018). Impact of intensified pharmaceutical interventions in medication adherence in chronic kid-ney disease patients. Journal of young pharmacists, 10(2), 208.
Cooney, D., Moon, H., Liu, Y., Miller, R. T., Perzynski, A., Watts, B., & Drawz, P. E. (2015). A pharma-cist based intervention to improve the care of patients with CKD: a pragmatic, randomized, controlled trial. BMC nephrology, 16, 1-9.
Daifi, C., Feldpausch, B., Roa, P. A., & Yee, J. (2021). Implementation of a clinical pharmacist in a hemodialysis facility: A quality improvement report. Kidney Medicine, 3(2), 241-247.
Dyer, S. A., Nguyen, V., Rafie, S., & Awdishu, L. (2022). Impact of medication reconciliation by a di-alysis pharmacist. Kidney360, 10.34067/KID.0007182021. https://doi.org/10.34067/kid.0007182021
Ebbens, M. M., Errami, H., Moes, D. J. A. R., van den Bemt, P. M. L. A., van der Boog, P. J. M., & Gombert-Handoko, K. B. (2019). Prevalence of medication transfer errors in nephrology pa-tients and potential risk factors. European Journal of Internal Medicine, 70, 50–53. https://doi.org/10.1016/j.ejim.2019.09.003
Ebbens, M. M. (2021). MEDICATION RECONCILIATION- risk factors and ways to improve efficiency marieke M. (Publicação n.º 978-94-93197-83-1) [Dissertação de doutorado não publicada]. Erasmus University Rotterdam.
Graça, D. D. D. C., & Junior, W. V. M. (2018). Construction and evaluation of medication reconcilia-tion instruments for pediatric patients. Revista Brasileira de Farmácia Hospitalar e Serviços de Saúde, 9(4), e094-005.
Härkänen, M., Vehviläinen-Julkunen, K., Murrells, T., Rafferty, A. M., & Franklin, B. D. (2019). Med-ication administration errors and mortality: Incidents reported in England and Wales be-tween 2007 ̶ 2016. Research in Social and Administrative Pharmacy, 15(7), 858–863. https://doi.org/10.1016/j.sapharm.2018.11.010
Hawley, C. E., Triantafylidis, L. K., & Paik, J. M. (2019). The missing piece: Clinical pharmacists en-hancing the interprofessional nephrology clinic model. Journal of the American Pharmacists Association, 59(5), 727–735. https://doi.org/10.1016/j.japh.2019.05.010
Hias, J., Van der Linden, L., Spriet, I., Vanbrabant, P., Willems, L., Tournoy, J., & De Winter, S. (2017). Predictors for unintentional medication reconciliation discrepancies in preadmission medication: A systematic review. European Journal of Clinical Pharmacology, 73(11), 1355–1377. https://doi.org/10.1007/s00228-017-2308-1
Ibrahim, J., Hazzan, A. D., Mathew, A. T., Sakhiya, V., Zhang, M., Halinski, C., & Fishbane, S. (2017). Medication discrepancies in late-stage chronic kidney disease. Clinical Kidney Journal, 11(4), 507–512. https://doi.org/10.1093/ckj/sfx135
Johnston, R., Saulnier, L., & Gould, O. (2010). Best possible medication history in the emergency department: Comparing pharmacy technicians and pharmacists. The Canadian Journal of Hospital Pharmacy, 63(5). https://doi.org/10.4212/cjhp.v63i5.947
Liu, X.-X., Wang, H.-X., Hu, Y.-Y., Zhu, X.-T., Tan, X., Yang, Y., Hang, Y.-F., & Zhu, J.-G. (2021). Drug-related problems identified by clinical pharmacists in nephrology department of a ter-tiary hospital in China—a single center study. Annals of Palliative Medicine, 10(8), 8701–8708. https://doi.org/10.21037/apm-21-817
Luz, C. M. d., Deitos, J., Siqueira, T. C., & Heck, A. P. F. (2017). Completude das informações do re-gistro hospitalar de câncer em um hospital de Florianópolis. ABCS Health Sciences, 42(2). https://doi.org/10.7322/abcshs.v42i2.1006
Medication reconciliation to prevent adverse drug events | IHI - institute for healthcare improvement. (2021). Improving Health and Health Care Worldwide | IHI - Institute for Healthcare Im-provement. https://www.ihi.org/Topics/ADEsMedicationReconciliation/Pages/default.aspx
Mendes, A. E. M (2016). Conciliação medicamentosa da admissão hospitalar: um ensaio clínico ran-domizado [Dissertação de mestrado]. Dspace. https://acervodigital.ufpr.br/handle/1884/42441?show=full
Pevnick, J. M., Shane, R., & Schnipper, J. L. (2016). The problem with medication reconciliation. BMJ Quality & Safety, 25(9), 726–730. https://doi.org/10.1136/bmjqs-2015-004734
Phillips, M., Wilson, J. A., Aly, A., Wood, M., Poyah, P., Drost, S., ... & Carver, H. (2017). An Evalua-tion of Medication Reconciliation in an Outpatient Nephrology Clinic. CANNT Journal= Journal ACITN, 26(2), 29-33.
Portaria nº 529: Institui o Programa Nacional de Segurança do Paciente (PNSP), Portaria n.º 529 (2013) (Brasil). https://bvsms.saude.gov.br/bvs/saudelegis/gm/2013/prt0529_01_04_2013.html
Schnipper, J. L., Mixon, A., Stein, J., Wetterneck, T. B., Kaboli, P. J., Mueller, S., Labonville, S., Mi-nahan, J. A., Burdick, E., Orav, E. J., Goldstein, J., Nolido, N. V., & Kripalani, S. (2018). Ef-fects of a multifaceted medication reconciliation quality improvement intervention on pa-tient safety: Final results of the MARQUIS study. BMJ Quality & Safety, 27(12), 954–964. https://doi.org/10.1136/bmjqs-2018-008233
Song, Y. K., Jeong, S., Han, N., Na, H., Jang, H. Y., Sohn, M., ... & DrugTEAM Study Group. (2021). Effectiveness of clinical pharmacist service on drug-related problems and patient outcomes for hospitalized patients with chronic kidney disease: a randomized controlled trial. Journal of Clinical Medicine, 10(8), 1788.
Tam, V. C. (2005). Frequency, type and clinical importance of medication history errors at admission to hospital: a systematic review. Canadian Medical Association Journal, 173(5), 510–515. https://doi.org/10.1503/cmaj.045311
The Joint Commission. (2016). National patient safety goals. www.jointcommission.org. http://www.jointcommission.org/assets/1/6/2016_NPSG_HAP.pdf
The Joint Commission. (2021). National patient safety goals® effective january 2021 for the behavior-al health care and human services program (NPSG.01.01.01). DSSM. https://www.jointcommission.org/-/media/tjc/documents/standards/national-patient-safety-goals/2021/npsg_chapter_bhc_jan2021.pdf
Thomas, D. B., Oenning, N. S. X., & Goulart, B. N. G. d. (2018). Essential aspects in the design of data collection instruments in primary health research. Revista CEFAC, 20(5), 657–664. https://doi.org/10.1590/1982-021620182053218
Van Der Gaag, S., Janssen, M. J. A., Wessemius, H., Siegert, C. E. H., & Karapinar-Çarkit, F. (2017). An evaluation of medication reconciliation at an outpatient Internal Medicines clinic. Euro-pean Journal of Internal Medicine, 44, Artigo e32-e34. https://doi.org/10.1016/j.ejim.2017.07.015
Wilson, J.-A. S., Ladda, M. A., Tran, J., Wood, M., Poyah, P., Soroka, S., Rodrigues, G., & Tennanko-re, K. (2017). Ambulatory medication reconciliation in dialysis patients: Benefits and com-munity practitioners’ perspectives. The Canadian Journal of Hospital Pharmacy, 70(6). https://doi.org/10.4212/cjhp.v70i6.1719
World Health Organization. (2017). Medication Without Harm. https://www.who.int/publications/i/item/WHO-HIS-SDS-2017.
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