Rentero L, Iniesta C, Urbieta E, Madrigal M, Pérez M D
Residente cuarto año. Servicio de Farmacia. Hospital General Universitario Reina Sofía de Murcia..
Dr. en Farmacia. FEA Farmacia Hospitalaria. Servicio de Farmacia. Hospital General Universitario Reina Sofía de Murcia..
Farm Hosp. 2014 Sep 16;38(5):398-404. doi: 10.7399/fh.2014.38.5.1136.
The objective of this study was to determine the main causes of errors of medication reconciliation at hospital admission in medical and surgical department and establish factors associated with medication reconciliation errors.
Cross-sectional study. We included all patients admitted to two services and two surgical for a month. To determine the presence of error reconciliation, the pharmacist compared the medication history interview by the order physician. The factors associated with errors were identified by multivariate logistic regression analysis.
221 patients were included, of which 58.4% had at least one error reconciliation. We detected 629 discrepancies, 339 (53.9%) reconciliation errors. The incidence of errors in medical services was 24.3% and in the surgical services 43.0% (p <0.001) in both groups being most prevalent error of omission (46.2% and 50.8%). Regarding factors associated, the equation determines that patients older than 65 years, polymedicated and taking oral antidiabetic are more likely to have an error with a sensibility of 75.2% and a specificity of 68.5%.
There is a high rate of error reconciliation in medical and surgical patients, which confirms the need to implement a strategy to reduce these errors. Given the difficulty of applying the process to all patients, the strategy must be directed to patients who are at increased risk of error.
本研究的目的是确定内科和外科住院患者用药核对错误的主要原因，并确定与用药核对错误相关的因素。
横断面研究。我们纳入了两个内科科室和两个外科科室一个月内收治的所有患者。为确定是否存在核对错误，药剂师将医嘱医生采集的用药史进行了对比。通过多因素逻辑回归分析确定与错误相关的因素。
共纳入221例患者，其中58.4%至少存在一项核对错误。我们共检测到629处差异，其中339处（53.9%）为核对错误。内科的错误发生率为24.3%，外科为43.0%（p<0.001），两组中最常见的错误类型均为漏记（分别为46.2%和50.8%）。关于相关因素，该方程确定65岁以上、用药种类多且服用口服降糖药的患者更有可能出现错误，敏感度为75.2%，特异度为68.5%。
内科和外科患者的用药核对错误率很高，这证实了有必要实施一项策略来减少这些错误。鉴于将该流程应用于所有患者存在困难，该策略必须针对错误风险增加的患者。
