Objective:

To analyze the medication reconciliation errors in the Emergency Department (ED) of a third level hospital. Methods: Prospective study from November-2019 to February-2020 in the Observation and Short Stay units of the ED. All polymedicated patients were included. The reconciliation circuit followed the guidelines of the FASTER method, a methodology validated and developed by the RedFaster group. Variables collected: age, sex, chronic medications, unjustified discrepancies (unresolved discrepancies and reconciliation errors), type of error and drug involved. Reconciliation errors were classified according to their severity, whether they involved high-risk drugs or whether they could cause withdrawal syndrome.

Results:

380 patients were included. Mean age: 74 years (28-95). 61% men. A total of 3,529 chronic drugs were reviewed [9 drugs/patient (5-20)], and 375 unjustified discrepancies were recorded (81% reconciliation errors and 19% unresolved discrepancies). The most frequent type of error was the omission of medication (58%), and drugs most often involved were sedative-hypnotics (16%) followed by hypolipemics (12%). In 45% of the errors some high-risk medication was involved, and in 32% of the omissions, medications that could cause withdrawal syndrome.

Conclusion:

These results corroborate the idea that medication reconciliation is an important practice for patient safety, especially in polymedicated patients. The characteristics of the EDs make them especially vulnerable to the appearance of medication errors, so the inclusion of a pharmacist as a responsible for reconciliation programs is justified.

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