التسويات الدوائية للمرضى المدخلين للاقسام الجراحية: دراسة في مستشفى اريحا
Medication Reconciliation at Admission to Surgical Departments: A Study at Jericho Hospital
محمد ابراهيم 'محمد رشيد' عتيلي
Mohammed Ibrahim 'Moh. Rasheed' Attili
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Background: Adverse Drug Events (ADEs) at care transition expose patients to susceptible harm. Lack of medication reconciliation is a major factor leading to ADEs. It is highly important to apply medication reconciliation at care transitions to minimize medication discrepancies and reduce medication errors. Some patients are at higher risk due to medication errors: those with chronic diseases and poly-pharmacy, elder patients, those with other co-morbid factors and patients who are admitted to certain surgical procedure. Aim:The study aims to assess prevalence and factors associated with medication discrepancies at admission to surgical operation in hospitals using the Electronic Medical Record (EMR) system and to analyze the factors associated with medication discrepancies. Method: A prospective cross-sectional observational design was employed. The study was done in Jericho Governmental Hospital. The inclusion criteria was all patients who were aged ≥18 years old, who were admitted for any surgical operation in the hospital at least for 24 hours and underwent major surgery. Data were collected in the period between the middle of July to the end of September, 2016, over a period of 75 days. All patients who were admitted to surgical operation and met the criteria were included. Findings: A total of 145 patients who satisfy the criteria were included, 19.3% of them hadat least one medication discrepancy, 93% of these discrepancies were unintentional. Moreover, 93% of the discrepancies were omission of certain medication at time of admission, 20.7% of discrepancies occurred in patients taking 1-2 medications prior to admission and 7.6% in patients taking 3 or more medications. Logistic regression showed significant association between medication discrepancy and having a chronic disease(Exp(B) = 12.910, P <0.001), and with the number of medication consumed prior to admission (Exp (B) = 23.953, P <0.001). Conclusion: The risk of medication discrepancy was higher in patients with chronic disease and polypharmacy. The most frequent medication discrepancy was omission of certain medication consumed prior to admission. Therefore, medication reconciliation should be carried out for susceptible patients who have chronic diseases or consuming medication regularly at time of admission. Moreover, medication discrepancies may occur at any care transition other than admission, so it is highly important to perform medication reconciliation at any care transition.