[Conciliation discrepancies at hospital discharge].
OBJECTIVE
To evaluate and describe the non-justified discrepancies found on reconciling chronic medication prescribed to patients when discharged from hospital. Secondly, the impact of the reconciliation process is evaluated by assessing the seriousness of the discrepancies.


METHODS
Cality study.


METHODS
Short Stay Medical Unit in Elda General Hospital, Alicante, Spain.


METHODS
All patients discharged were included.


METHODS
The medication that the patient was taking before admission was obtained by personal interview before being discharged. The discrepancies that were non-justifiable with the treatment on discharge and with the pharmacotherapeutic history were identified and modified, where necessary, after consulting with the doctor. MEDITIONS AND RESULTS: Of the 434 patients interviewed, 249 conciliation errors were detected, which was 0.57 discrepancies per treated patient. Among the 35.2% of patients who had conciliation errors, the mean number of discrepancies was 1.62. Of these errors, 153 (61.5%) were produced when being discharged, while 96 (38.5%) were errors of omission or commission in the pharmacotherapeutic history. Of all the discharge reports reviewed, 11% did not record information on the previous treatment of the patient. Omission was the main type of error, both in the history and on discharge. As regards the potential harm of the detected errors, 30% could have caused temporary harm or hospitalisation.


CONCLUSIONS
Medication errors in the pharmacotherapeutic history at the time of being admitted are common and potentially significant if they are continued. Including the pharmacist in the medical team, along with being able to access data at the different care levels, could help to reduce the frequency of these errors.
Hernández Prats
Carmen
C
Servicio de Farmacia, Hospital General de Elda, Elda. Alicante. España. hernandez_carpra@gva.es
Mira Carrió
Amalia
A
Arroyo Domingo
Elena
E
Díaz Castellano
Manuel
M
Andreu Giménez
Lucio
L
Sánchez Casado
M Isabel
MI
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data*; D008875:Middle Aged; D010351:Patient Discharge; D011446:Prospective Studies; D055815:Young Adult