title: [Medication reconciliation: From admission to primary care].
abstract: OBJECTIVE
  To implement a medication reconciliation circuit of inter-level, comprehensive and multidisciplinary approach in an integrated health organization. To measure the discrepancies detected in each of the steps studied.
  
  
  METHODS
  A prospective intervention study of one-year duration. The medication is reconciled at admission to the hospital, at discharge and when the patient goes to his Primary Care physician. The number and type of discrepancies detected each time the medication is reconciled are collected and resolved, as well as the total number of drugs before and after each reconciliation process quantified.
  
  
  RESULTS
  Between November 1, 2013 and October 31, 2014 the medication had been reconciled to 77 patients, 63% male, mean age 69,5 years. Mean admission discrepancy per patient was 7,85, 3,67 at discharge and 2,19 at Primary Care.
  
  
  CONCLUSIONS
  This program of medication reconciliation, in addition to detect and resolve discrepancies, has been a starting point for establishing new channels of communication between the different health professionals who have participated in the program and disseminate the safety culture within the organization.
authors.affiliation: Servicio de Farmacia, Organización Sanitaria Integrada Bidasoa, Hospital Bidasoa, Hondarribia, Gipuzkoa, España. Electronic address: elena.valverdebilbao@osakidetza.eus.
authors.forename: E
authors.initials: E
authors.lastname: Valverde
authors.affiliation: Servicio de Farmacia, Organización Sanitaria Integrada Bidasoa, Hospital Bidasoa, Hondarribia, Gipuzkoa, España.
authors.forename: A
authors.initials: A
authors.lastname: Mendizabal
authors.affiliation: Servicio de Farmacia, Organización Sanitaria Integrada Bidasoa, Hospital Bidasoa, Hondarribia, Gipuzkoa, España.
authors.forename: C
authors.initials: C
authors.lastname: Ariz
authors.affiliation: Servicio de Farmacia, Organización Sanitaria Integrada Bidasoa, Hospital Bidasoa, Hondarribia, Gipuzkoa, España.
authors.forename: I
authors.initials: I
authors.lastname: Mitxelena
authors.affiliation: Servicio de Enfermería, Organización Sanitaria Integrada Bidasoa, Hospital Bidasoa, Hondarribia, Gipuzkoa, España.
authors.forename: A
authors.initials: A
authors.lastname: Pérez
authors.affiliation: Servicio de Enfermería, Organización Sanitaria Integrada Bidasoa, Hospital Bidasoa, Hondarribia, Gipuzkoa, España.
authors.forename: V
authors.initials: V
authors.lastname: Igea
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008508:Medication Errors; D059065:Medication Reconciliation; D008875:Middle Aged; D010343:Patient Admission; D010351:Patient Discharge; D011320:Primary Health Care; D011446:Prospective Studies; D000069341:Transitional Care
keywords: Admission; Alta; Atención primaria; Conciliación de la medicación; Discharge; Discrepancias; Discrepancies; Ingreso; Medication reconciliation; Primary care