Medication reconciliation in emergency departments

Calderón Hernanz B, Oliver Noguera A, Tomás Vecina S, Baena Parejo MI, García Peláez M, Juanes Borrego A, Calleja Hernández MA, Altimiras Ruiz J, Roqueta Egea F, Chánovas Borrás M

Medication errors, which are common in hospitals, lead to higher morbidity, mortality,

and expenditure. Errors are most common when patients are transferred from one level

of care to another, and the likelihood of mistakes is higher in emergency departments

because of the intrinsic nature of emergency care. The internationally recognized

remedy for this situation is medication reconciliation, defined as the process of obtaining

a complete, accurate list of the patient’s prior medications and comparing it to the list of

medicines prescribed after admission to a new level of care. Discrepancies should be

considered and prescriptions changed if necessary. Both the person who will be

responsible for the next phase of care and the patient should be informed of the new list

of medications. This consensus statement offers a set of general recommendations for

medication reconciliation. Specific recommendations for each subgroup of medications

are also included to allow emergency department prescribing to be tailored to individual

patient characteristics. The recommendations in this statement should be overridden in

some cases if the risk-benefit ratio suggests that further individualization is required.

Individualized assessment of medications should be carried out by a multidisciplinary

team responsible for the patients care.

Altimiras Ruiz J, Baena Parejo MI, Calderón Hernanz B, Calleja Hernández MA, Chanovas Borràs M, García Peláez M, Juanes Borrego A, Oliver Noguera A, Roqueta Egea F, Tomás Vecina S