4CPS-251 Pharmacist in the emergency department to optimise medication reconciliation during the admission

BackgroundMedication reconciliation (MR) remains a problem at the hospital admission.PurposeTo describe the activity, after the physical integration of a pharmacist in the Emergency Department, focusing on MR at the hospital. To analyse the characteristics of reconciled patients.Material and methodsSix-months’ data were analysed after the implementation of an emergency pharmacist 2 h/day for MR at the hospital income. The pharmacist checked hospital treatment at the admission and, in parallel, checked if the physician had done the MR correctly. To the patients not reconciled by the physician, a report on the medical history was done by the pharmacist after a pharmacotherapeutic interview. All patients>18 years were included. The information was collected in a database including demographic variables, type of medical service (categorised in medical or surgical) and type of MR (made by pharmacist, by physician or by physician with errors). Descriptive statistics, quantitative variables such as average and standard deviation, and qualitative variables using frequency and percentage distribution were discussed. We studied by Chi-square test the relationship between the reconciliation made by the pharmacist concerning whether the patient entered the medical or surgical specialty.ResultsFive hundred and fifty-six patients were reviewed, of these 78.2% (435 patients) had previous medication, with an average age of 69±15 years (66% elderly), 58.9% males. Seventy-three per cent of patients with medication were admitted to medical specialties, mainly internal medicine (33% of the total) and cardiology (17%). The remaining 27% entered surgical specialties, mainly surgery (9%) and urology (8%). Of the total of MR made, 44.8% were performed correctly by the physician, 15.4% by the physician but with some errors, and 39.8% were reconciled by the pharmacist. It was observed that a percentage much greater of MR was performed by the pharmacist in surgical specialties (56.8%) and this was lower in the medical specialties (33.4%) (p