The effect on potential adverse drug events of a pharmacist-acquired medication history in an emergency department: a multicentre, double-blind, randomised, controlled, parallel-group study.
BACKGROUND
Potential adverse drug events (PADEs) are defined as being potentially harmful unintentional medication discrepancies. Discrepancies regarding medication history (MH) often occur when a patient is being admitted to a hospital's emergency department (ED); they are clinically important and represent a significant source of data regarding adverse drug events occurring during emergency admission to hospital. This study sought to measure the impact of pharmacist-acquired MH during admission to an ED; it focused on whether a patient's current home medication regimen being available for a doctor when consulting a patient in an ED would have reduced potential adverse drug events.


METHODS
A multicentre, double-blind, randomised, controlled parallel-group study was carried out at 3 large teaching hospitals in Bogota, Colombia. Two hundred and seventy patients who had been admitted to an ED were enrolled; each had a standardised, comprehensive MH interview, focusing on a patient's current home medication regimen prior to being seen by a doctor. Data recorded on the admission medication order form was available to be used by a doctor during consultation in the ED. The main outcome dealt with comparing the intervention and control groups regarding the percentage of patients having at least 1 potential adverse drug event.


RESULTS
There were 811 PADE (3.35 per patient), 528 (65%) on the standard care arm and 283 (35%) on an intervention arm. Most PADEs were judged to have had the potential to cause moderate discomfort (42.6%), 33.4% were deemed unlikely to have caused harm and 23.9% were judged to have had the potential to cause clinical deterioration.


CONCLUSIONS
Many patients suffer potentially adverse drugs events during the transition of care from home to a hospital. Patient safety-focused medication reconciliation during admission to an ED involving a pharmacist and drawing up a history of complete medication could contribute towards reducing the risk of PADES occurring and improve follow-up of patients' medication-based therapy.


BACKGROUND
28/10/2012, ISRCTN63455839.
Universidad Nacional de Colombia, Ciudad Universitaria Edificio 450 Oficina 204, Bogota, 111321, Cundinamarca, Colombia. jbecerrac@unal.edu.co.
Jesus
J
Becerra-Camargo
Pharmacy Department, Universidad de Granada, Granada University's Pharmaceutical Care Research Institute, Paseo Cartuja, S/N, 18071, Granada, Spain. femartin@ugr.es.
Fernando
F
Martínez-Martínez
Pharmacy Department, Universidad de Granada, Granada University's Pharmaceutical Care Research Institute, Paseo Cartuja, S/N, 18071, Granada, Spain. emiliogarciajimenez@gmail.com.
Emilio
E
García-Jiménez
D000368:Aged; D003105:Colombia; D004311:Double-Blind Method; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization; D006784:Hospitals, Teaching; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D059065:Medication Reconciliation; D008875:Middle Aged; D010343:Patient Admission; D061214:Patient Safety; D010595:Pharmacists; D012017:Referral and Consultation