title: [Impact of a software application to improve medication reconciliation at hospital discharge].
abstract: OBJECTIVE
  To assess the impact of a software application to improve the quality of information concerning current patient medications and changes on the discharge report after hospitalization. To analyze the incidence of errors and to classify them.
  Quasi-experimental pre / post study with non-equivalent control group study.
  
  
  METHODS
  Medical patients at hospital discharge.
  
  
  METHODS
  implementation of a software application.
  
  
  METHODS
  Percentage of reconciled patient medication on discharge, and percentage of patients with more than one unjustified discrepancy.
  
  
  RESULTS
  A total of 349 patients were assessed; 199 (pre-intervention phase) and 150 (post-intervention phase). Before the implementation of the application in 157 patients (78.8%) medication reconciliation had been completed; finding reconciliation errors in 99 (63.0%). The most frequent type of error, 339 (78.5%), was a missing dose or administration frequency information. After implementation, all the patient prescriptions were reconciled when the software was used. The percentage of patients with unjustified discrepancies decreased from 63.0% to 11.8% with the use of the application (p<.001). The main type of discrepancy found on using the application was confusing prescription, due to the fact that the professionals were not used to using the new tool.
  
  
  CONCLUSIONS
  The use of a software application has been shown to improve the quality of the information on patient treatment on the hospital discharge report, but it is still necessary to continue development as a strategy for improving medication reconciliation.
authors.affiliation: Servicio de Farmacia, Hospital San Juan de Dios del Aljarafe, Sevilla, España. Electronic address: susana.corral@sjd.es.
authors.forename: S
authors.initials: S
authors.lastname: Corral Baena
authors.affiliation: Servicio de Farmacia, Hospital San Juan de Dios del Aljarafe, Sevilla, España.
authors.forename: M J
authors.initials: MJ
authors.lastname: Garabito Sánchez
authors.affiliation: Servicio de Calidad, Hospital San Juan de Dios del Aljarafe, Sevilla, España.
authors.forename: M V
authors.initials: MV
authors.lastname: Ruíz Rómero
authors.affiliation: Servicio de Medicina, Hospital San Juan de Dios del Aljarafe, Sevilla, España.
authors.forename: M A
authors.initials: MA
authors.lastname: Vergara Díaz
authors.affiliation: Departamento Informática, Hospital San Juan de Dios del Aljarafe, Sevilla, España.
authors.forename: E R
authors.initials: ER
authors.lastname: Martín Chacón
authors.affiliation: Servicio de Medicina, Hospital San Juan de Dios del Aljarafe, Sevilla, España.
authors.forename: A
authors.initials: A
authors.lastname: Fernández Moyano
mesh_terms: D000328:Adult; D000368:Aged; D065187:Controlled Before-After Studies; D004334:Drug Administration Schedule; D011307:Drug Prescriptions; D057286:Electronic Health Records; D055695:Electronic Prescribing; D005260:Female; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000517:prevention & control; D059065:Medication Reconciliation / Q000458:organization & administration*; D008875:Middle Aged; D010351:Patient Discharge; D010818:Practice Patterns, Physicians'; D019984:Quality Indicators, Health Care; D012984:Software
keywords: Alta hospitalaria; Chronic medication; Conciliación medicación; Error de medicación; Hospital discharge; Medicación crónica; Medication error; Medication reconciliation; Promoción de la seguridad; Safety promotion