title: Development and multi-centre evaluation of a method for assessing the severity of potential harm of medication reconciliation errors at hospital admission in elderly.
abstract: BACKGROUND
  Medication reconciliation is a powerful process to correct medication errors (ME) resulting from miscommunicated information at transitions of care. This study aims to develop and evaluate a scoring method for assessing the severity of potential harm of ME intercepted by medication reconciliation at hospital admission in elderly.
  
  
  METHODS
  The development of the scoring method was based on a literature search and the creation of a list of high-risk drugs used in outpatient care. The evaluation of the method was carried out in 7 French hospitals and was based on two criteria: the inter-rater reliability and acceptability. The assessment of the inter-rater reliability was based on intra-class correlation coefficient (ICC) calculations. Each hospital prospectively enrolled the 10 first patients aged 65 or older presenting with at least one ME. Seven blocks of 10 patients were formed. After randomization, each block was rated by practitioners from 3 hospitals. The assessment of the acceptability was based on a satisfaction questionnaire.
  
  
  RESULTS
  A clinical algorithm was developed. The inter-rater reliability of the method was validated by the overall agreement of the 7 hospitals ratings. The agreement was at least substantial (ICC>0.60) and in most of cases almost perfect (ICC>0.80). The acceptability of the method was judged as satisfactory.
  
  
  CONCLUSIONS
  This multi-centre project has validated an instrument for assessing the severity of potential harm of ME intercepted by medication reconciliation. This will allow studies to be conducted with large cohorts of patients in order to develop epidemiological databases of ME of potential clinical significance.
authors.affiliation: Department of Pharmacy, Lunéville Hospital, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Doerper
authors.affiliation: Department of Medical Information, University Hospital of Strasbourg, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Godet
authors.affiliation: Department of Internal Medicine, University Hospital of Bichat-Claude Bernard, Paris, France.
authors.forename: Jean François
authors.initials: JF
authors.lastname: Alexandra
authors.affiliation: Department of Pharmacy, University Hospital of Grenoble, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Allenet
authors.affiliation: Department of Internal Medicine, University Hospital of Strasbourg, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Andres
authors.affiliation: Department of Pharmacy, University Hospital of Grenoble, France.
authors.forename: Pierrick
authors.initials: P
authors.lastname: Bedouch
authors.affiliation: Department of Pharmacy, Compiegne Hospital, France.
authors.forename: Anne Charlotte
authors.initials: AC
authors.lastname: Desbuquois
authors.affiliation: Department of Pharmacy, University Hospital of Nimes, France.
authors.forename: Armèle
authors.initials: A
authors.lastname: Develay-Rambourg
authors.affiliation: Department of Geriatric, Compiegne Hospital, France.
authors.forename: Odile
authors.initials: O
authors.lastname: Bauge-Faraldi
authors.affiliation: Department of Epidemiology and Clinical Evaluation, University Hospital of Nancy, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Gendarme
authors.affiliation: Department of Pharmacy, University Hospital of Strasbourg, France.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Gourieux
authors.affiliation: Department of Pharmacy, St Marcellin Hospital, France.
authors.forename: Amandine
authors.initials: A
authors.lastname: Grain
authors.affiliation: Department of Pharmacy, University Hospital of Bichat-Claude Bernard, Paris, France.
authors.forename: Kivan
authors.initials: K
authors.lastname: Long
authors.affiliation: Omedit Aquitaine, Bordeaux, France.
authors.forename: Bertrice
authors.initials: B
authors.lastname: Loulière
authors.affiliation: Omedit Aquitaine, Bordeaux, France.
authors.forename: Myriam
authors.initials: M
authors.lastname: Roudot
authors.affiliation: Department of Geriatric, St Marcellin Hospital, France.
authors.forename: Marie Christine
authors.initials: MC
authors.lastname: Roussel-Galle
authors.affiliation: Department of Pharmacy, University Hospital of Nimes, France.
authors.forename: Clarisse
authors.initials: C
authors.lastname: Roux-Masson
authors.affiliation: Department of Epidemiology and Clinical Evaluation, University Hospital of Nancy, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Thilly
authors.affiliation: Department of Pharmacy, Lunéville Hospital, France.
authors.forename: Edith
authors.initials: E
authors.lastname: Dufay
authors.affiliation: Department of Pharmacy and HuManiS (EA7308), University Hospital of Strasbourg, France. Electronic address: bruno.michel@chru-strasbourg.fr.
authors.forename: Bruno
authors.initials: B
authors.lastname: Michel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007388:Internal Medicine; D008297:Male; D059065:Medication Reconciliation / Q000379:methods*; D061214:Patient Safety; D010607:Pharmacy Service, Hospital / Q000592:standards*; D015203:Reproducibility of Results; D012107:Research Design / Q000592:standards*; D011795:Surveys and Questionnaires
keywords: Internal medicine; Medication error; Medication reconciliation; Patient safety; Pharmaceutical care; Scoring method