[Assessment of a reconciliation and information programme for heart transplant patients].
BACKGROUND
The objective is to assess a pharmaceutical care programme for heart transplant patients upon patient admission and discharge.


METHODS
Observational study of heart transplant patients, performed during the first quarter of 2007. Upon admission, the patient was interviewed regarding home treatments, adherence, allergies and adverse effects, and his/her prescriptions were compared with the last discharge report (drug reconciliation). At time of discharge, treatment was checked against the last hospital prescription (reconciliation) and an informative report was drawn up and personally delivered to the patient. Subsequently, a satisfaction questionnaire was carried out by telephone. Drug-related problems were recorded using Atefarm software.


RESULTS
The programme was applied to 24 patients upon admission and 23 upon discharge. No drug interactions were detected. Treatment adherence was higher than 90%. 37.5% of patients informed of an adverse reaction. Medication-related problems were identified in 16 patients (45.7%) for 6.6% of medications, most of which (38%) were for infection prophylaxis; medication omission was the most frequently-detected error. Positive evaluation of the information that was received was higher than 90%.


CONCLUSIONS
Pharmacotherapeutic follow-up upon admission and discharge resolves and prevents problems while improving patient information and satisfaction. Limitations on personnel prevent the population's requests from being met.
Servicio de Farmacia, Hospital Universitario La Fe, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain. hernandez_julmar@gva.es
J
J
Hernández Martín
M
M
Montero Hernández
I
I
Font Noguera
L
L
Doménech Moral
V
V
Merino Sanjuán
J L
JL
Poveda Andrés
D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D059065:Medication Reconciliation; D008875:Middle Aged; D010343:Patient Admission; D010351:Patient Discharge; D017060:Patient Satisfaction; D010607:Pharmacy Service, Hospital; D015397:Program Evaluation; D011795:Surveys and Questionnaires