<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0213-9111</journal-id>
<journal-title><![CDATA[Gaceta Sanitaria]]></journal-title>
<abbrev-journal-title><![CDATA[Gac Sanit]]></abbrev-journal-title>
<issn>0213-9111</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0213-91112025000102211</article-id>
<article-id pub-id-type="doi">10.1016/j.gaceta.2025.102501</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Conciliación de la medicación al alta en una unidad de psicogeriatría]]></article-title>
<article-title xml:lang="en"><![CDATA[Medication reconciliation at discharge in a psychogeriatric unit]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[San Juan Muñoz]]></surname>
<given-names><![CDATA[Adriana Elena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[O&#8217;Hara Veintimilla]]></surname>
<given-names><![CDATA[Kevin]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferro Uriguen]]></surname>
<given-names><![CDATA[Alexander]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Laso Lucas]]></surname>
<given-names><![CDATA[Esther]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Beobide Telleria]]></surname>
<given-names><![CDATA[Idoia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez Alderete]]></surname>
<given-names><![CDATA[Leire]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Latasa Berasategui]]></surname>
<given-names><![CDATA[Ane]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Goienetxea Sasiain]]></surname>
<given-names><![CDATA[Uxue]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Matia Servicio de Farmacia ]]></institution>
<addr-line><![CDATA[San Sebastián ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Matia Unidad de Psicogeriatría ]]></institution>
<addr-line><![CDATA[San Sebastián ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de Deusto Facultad de Ciencias de la Salud ]]></institution>
<addr-line><![CDATA[Bilbao ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Universitario Donostia Servicio de Farmacia ]]></institution>
<addr-line><![CDATA[San Sebastián ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Universidad del País Vasco Facultad de Farmacia ]]></institution>
<addr-line><![CDATA[Vitoria ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<volume>39</volume>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0213-91112025000102211&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0213-91112025000102211&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0213-91112025000102211&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Objetivo: Analizar el impacto de la conciliación de la medicación al alta hospitalaria realizada por un equipo interdisciplinario en pacientes ingresados en la unidad de psicogeriatría de un hospital de media estancia.  Método: Estudio cuasiexperimental que comparó un grupo control histórico (GC) (febrero-mayo 2023) con un grupo de intervención (GI) entre febrero y mayo de 2024. Se detectaron las discrepancias por un farmacéutico hospitalario y se registró la resolución de la intervención propuesta al médico geriatra. Se recogieron variables sociodemográficas, clínicas, farmacológicas y económicas.  Resultados: Se estudiaron 58 pacientes en el GC y 54 en el GI. Se realizaron 83 intervenciones, de las cuales se aceptaron 56 (67,5%). Como consecuencia, disminuyeron la mediana del número de errores de conciliación por paciente (GI Me: 0 [RIC: 0-1] frente a GC Me: 1 [RIC: 0-2]; p = 0,024) y el porcentaje de pacientes con errores de conciliación al alta (GC 55,2% frente a GI 37%). Tras el alta, fue significativa la diferencia media en la carga anticolinérgica y sedante (DBI, Drug Burden Index) del GI (2,00 ± 0,69) respecto al GC (2,28 ± 0,59) (p = 0,023). En el GI disminuyó el número de prescripciones crónicas en 0,41 prescripciones (p = 0,006) y el DBI en 0,08 puntos de media (p = 0,032). La intervención ha supuesto un ahorro en el tratamiento del 6,94%, es decir, una media de 8,34 euros por paciente y mes (IC95%: 3,09-13,59; p = 0,002).  Conclusiones: La conciliación de la medicación al alta disminuye los errores de conciliación, el número de pacientes con errores de conciliación, las prescripciones crónicas y el DBI, suponiendo una mejora en la calidad asistencial y un ahorro económico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Objective: To analyze the impact of medication reconciliation at hospital discharge carried out by an interdisciplinary team on patients admitted to the psychogeriatric unit of a medium-stay hospital.  Method: A quasi-experimental study comparing a historical control group (CG) (February-May 2023) with an intervention group (IG) from February to May 2024. Discrepancies were identified by a hospital pharmacist, and the resolution of the proposed interventions was recorded after being discussed with the geriatrician. Sociodemographic, clinical, pharmacological, and economic variables were collected.  Results: 58 patients were studied in the CG and 54 in the IG. 83 interventions were performed, 56 (67.5%) accepted. As a result, the median number of reconciliation errors per patient (IG Me: 0 [RIC: 0-1] vs. CG Me: 1 [RIC: 0-2]; p = 0.024) and the percentage of patients with medication reconciliation errors at discharge decreased (CG 55.2% vs. IG 37%). Post-discharge, there was a significant mean difference in the Drug Burden Index (DBI) for the IG (2.00 ± 0.69) compared to the CG (2.28 ± 0.59) (p = 0.023). In the IG, the number of chronic prescriptions decreased by 0.41 prescriptions (p = 0.006), and the DBI was reduced by an average of 0.08 points (p = 0.032). The intervention led to a 6.94% savings in treatment costs, amounting to an average of D 8.34 per patient and month (95%CI: 3.09-13.59; p = 0.002).  Conclusions: Medication reconciliation at discharge reduces medication reconciliation errors, the number of patients with medication reconciliation errors, chronic prescriptions and the DBI, resulting in an improvement in healthcare quality and cost savings.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Conciliación de la medicación]]></kwd>
<kwd lng="es"><![CDATA[Alta]]></kwd>
<kwd lng="es"><![CDATA[Psicogeriatría]]></kwd>
<kwd lng="es"><![CDATA[Intervención]]></kwd>
<kwd lng="es"><![CDATA[Carga anticolinérgica]]></kwd>
<kwd lng="en"><![CDATA[Medication reconciliation]]></kwd>
<kwd lng="en"><![CDATA[Patient discharge]]></kwd>
<kwd lng="en"><![CDATA[Psychogeriatrics]]></kwd>
<kwd lng="en"><![CDATA[Interventions]]></kwd>
<kwd lng="en"><![CDATA[Anticholinergic burden]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Conciliación de la medicación]]></article-title>
<source><![CDATA[INFAC]]></source>
<year>2013</year>
<volume>21</volume>
<page-range>1-6</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ciapponi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Fernández Nievas]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
<name>
<surname><![CDATA[Seijo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Reducing medication errors for adults in hospital settings]]></article-title>
<source><![CDATA[Cochrane Database Syst Rev]]></source>
<year>2021</year>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Saavedra-Quirós]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Montero-Hernández]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Menchén-Viso]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Conciliación de la medicación al ingreso y alta hospitalaria. Una experiencia consolidada]]></article-title>
<source><![CDATA[Rev Calid Asist]]></source>
<year>2016</year>
<volume>31</volume>
<page-range>45-54</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Meijome Sánchez]]></surname>
<given-names><![CDATA[XM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anticiparse al error: dudas y recursos sobre fármacos en Castilla y León]]></article-title>
<source><![CDATA[Ene]]></source>
<year>2015</year>
<volume>9</volume>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="">
<collab>Ministerio de Sanidad, Consumo y Bienestar Social</collab>
<source><![CDATA[Recomendaciones de prácticas seguras en la conciliación de la medicación al alta hospitalaria en pacientes crónicos]]></source>
<year>2019</year>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kable]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Fraser]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Fullerton]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evaluation of the effect of a safe medication strategy on potentially inappropriate medications, polypharmacy and anticholinergic burden for people with dementia an intervention study]]></article-title>
<source><![CDATA[Healthcare (Basel)]]></source>
<year>2023</year>
<volume>11</volume>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Calvó-Perxas]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Turró-Garriga]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Aguirregomozcorta]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Psychotropic drugs in patients with Alzheimer's disease: a longitudinal study by the Registry of Dementias of Girona (ReDeGi) in Catalonia, Spain]]></article-title>
<source><![CDATA[J Am Med Dir Assoc]]></source>
<year>2014</year>
<volume>15</volume>
<page-range>497-503</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Olazarán]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Muñiz]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Síntomas psicológicos y conductuales de la demencia: de la sujeción química al correcto manejo]]></article-title>
<source><![CDATA[Serv Neurol]]></source>
<year>2017</year>
<page-range>1-12</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Olazarán-Rodríguez]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[López-Álvarez]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Agüera-Ortiz]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Criterios CHROME para la acreditación de centros libres de sujeciones químicas y para una prescripción de psicofármacos de calidad]]></article-title>
<source><![CDATA[Psicogeriatria]]></source>
<year>2016</year>
<volume>6</volume>
<page-range>91-8</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Park]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Baek]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical and economic impact of medication reconciliation by designated ward pharmacists in a hospitalist-managed acute medical unit]]></article-title>
<source><![CDATA[Res Soc Adm Pharm]]></source>
<year>2022</year>
<volume>18</volume>
<page-range>2683-90</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="confpro">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martínez García]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<source><![CDATA[Conciliación y adecuación de la medicación en el paciente crónico]]></source>
<year>2022</year>
<conf-name><![CDATA[ Jornada de Seguridad del Paciente 2022]]></conf-name>
<conf-date>2022</conf-date>
<conf-loc>Madrid </conf-loc>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sjölander]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Lindholm]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Pfister]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Impact of clinical pharmacist engagement in ward teams on the number of drug-related readmissions among older patients with dementia or cognitive impairment: an economic evaluation]]></article-title>
<source><![CDATA[Res Soc Adm Pharm]]></source>
<year>2019</year>
<volume>15</volume>
<page-range>287-91</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="">
<collab>Chronic Pharma</collab>
<source><![CDATA[Tools to optimize the pharmacotherapy of chronic patients]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Byrne]]></surname>
<given-names><![CDATA[CJ]]></given-names>
</name>
<name>
<surname><![CDATA[Walsh]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Cahir]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anticholinergic and sedative drug burden in community-dwelling older people: a national database study]]></article-title>
<source><![CDATA[BMJ Open]]></source>
<year>2018</year>
<volume>8</volume>
<page-range>1-8</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="">
<collab>AEMPS</collab>
<source><![CDATA[La incorporación del pictograma de conducción en los envases de medicamentos]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ayestaran-Altuna]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Delgado-Sánchez]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Garau-Gomila]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Guia per a la implantació de programes de conciliació de la medicació en els centres sanitaris]]></source>
<year>2010</year>
<publisher-loc><![CDATA[Barcelona ]]></publisher-loc>
<publisher-name><![CDATA[Societat Catalana de Farmàcia Clínica]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="">
<collab>Ministerio de Sanidad</collab>
<source><![CDATA[Nomenclátor digital]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="">
<collab>Osakidetza. Zuzendaritza Nagusia</collab>
<source><![CDATA[Tarifas para facturación de servicios sanitarios y docentes de Osakidetza para el año 2024]]></source>
<year>2023</year>
</nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[McGrattan]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Ryan]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Barry]]></surname>
<given-names><![CDATA[HE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Interventions to improve medicines management for people with dementia: a systematic review]]></article-title>
<source><![CDATA[Drugs Aging]]></source>
<year>2017</year>
<volume>34</volume>
<page-range>907-16</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mestres]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Agustí]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Hernandez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pharmacist intervention program at different rent levels of geriatric healthcare]]></article-title>
<source><![CDATA[Pharmacy]]></source>
<year>2017</year>
<volume>5</volume>
<page-range>27</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<collab>Panel UE</collab>
<article-title xml:lang=""><![CDATA[American Geriatrics Society 2023 updated AGS Beers Criteria(r) for potentially inappropriate medication use in older adults]]></article-title>
<source><![CDATA[J Am Geriatr Soc]]></source>
<year>2023</year>
<volume>71</volume>
<page-range>2052-81</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Delgado-Silveira]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Molina Mendoza]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
<name>
<surname><![CDATA[Montero-Errasquín]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Spanish version of the STOPP/START 3 criteria: advances in the detection of inappropriate prescribing medication in the older people]]></article-title>
<source><![CDATA[Rev Esp Geriatr Gerontol]]></source>
<year>2023</year>
<volume>58</volume>
</nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Seppala]]></surname>
<given-names><![CDATA[LJ]]></given-names>
</name>
<name>
<surname><![CDATA[Wermelink]]></surname>
<given-names><![CDATA[AMAT]]></given-names>
</name>
<name>
<surname><![CDATA[de Vries]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fall-risk-increasing drugs: a systematic review and meta-analysis: II. Psychotropics]]></article-title>
<source><![CDATA[J Am Med Dir Assoc]]></source>
<year>2018</year>
<volume>19</volume>
<numero>371</numero>
<issue>371</issue>
<page-range>e11-7</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
