Abstract: SA-PO1080
Medication Reconciliation at the Time of Admission and Discharge by Pharmacists in the Adult Nephrology Wards of a Referral Hospital in Iran
Session Information
- CKD: Epidemiology, Risk Factors, and Prevention - 3
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Author
- Karimzadeh, Iman, Shiraz University of Medical Sciences, Shiraz, Fars, Iran (the Islamic Republic of)
Background
Medication reconciliation is the process of identifying a precise list of drugs taken by a patient and comparing it to his/her current medications. The aim of the present research was investigating the impact of medication reconciliation by pharmacists at both admission and discharge in hospitalized patients with different kidney diseases.
Methods
A prospective, interventional study was conducted in two adult nephrology wards of a teaching, referral hospital in Iran from September 2020 to March 2021. All patients hospitalized in the nephrology ward for at least 1 day received the minimum of one medication during their ward stay within the study period were considered eligible. The best-possible medication history taken from each patient by an educated pharmacist was compared with prescribed medications at the time of ward admission and discharge from the ward. Medications were evaluated for possible intentional as well as non-intentional discrepancies.
Results
At ward admission and discharge, 178 and 134 patients were included. The mean number of un-intentional drug discrepancies per patient at ward admission and discharge was 6.13±4.13 and 1.63±1.94, respectively. The mean ± SD number of prescribed medications for patients before ward admission detected by pharmacist was significantly higher than that by nursing/physician (9.22±4.71 and 6.06±3.53, respectively [P=0.0001]). The number of unintentional medication discrepancies at ward admission has a significant association with the number of comorbidities (P = 0.043) and the number of administered medications (P = 0.023). At the time of ward discharge, only the number of comorbidities was significantly associated with the number of unintentional medication discrepancies (P = 0.031). Drug-drug interactions were observed in 97 (59.49%) of patients. At the time of ward discharge, all 134 subjects were given medication consult.
Conclusion
The rate of reconciliation errors at the time of ward admission and discharge was high in the adult nephrology ward. Implementing medication reconciliation program as a regular practice, preferably by pharmacists, in different phases of patient care in the hospital, especially for patients with numerous comorbidities like kidney diseases, is crucial.