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Medication reconciliation upon admission in paediatric hospital setting: preliminary data

  • Dolores Pilar Iturgoyen FuentesEmail author
  • Sagrario Martin-Aragon
  • Margarita Cuervas-Mons Vendrell
Research Article
  • 28 Downloads

Abstract

Background The benefits of medication reconciliation are well established in adult patients, but not in paediatric patients, being a population not included in the guidelines for medication reconciliation published so far. However, it is known that a significant number of children suffer from chronic illnesses leading to a complex pharmacological treatment. Moreover, there are a series of specific factors that cause a greater risk of medication errors in children. Aim The purpose of the present study was to determine whether patients from a paediatric hospital setting may benefit from medication reconciliation at hospital admission, in order to prevent and reduce prescribing errors on admission. Main outcome measures The primary outcome was the number of discrepancies between best possible medication history and prescribed treatment upon admission and, consequently, number of reconciliation errors. The secondary outcome was the main underlying disease with the highest number of reconciliation errors, and the main pharmacotherapeutic groups involved. Results The pharmacist reconciled the medication of 187 patients with an mean age of 6.6 ± 5.1 years. Sixty percent of patients had a base disease and 12.3% had polypharmacy, with an average of 6 drugs per patient. In a 42% of patients, at least one discrepancy was detected between their home treatment and the prescribed treatment upon admission, with 15% of patients having at least one reconciliation error (68% omissions). Neurological diseases were the main underlying disease with at least one reconciliation error (50%). The main pharmacotherapeutic groups involved in reconciliation errors were psychoanaleptic and psycholeptic, anti-acids, antiepileptic, and obstructive airway pharmacotherapy; each accounting for a 17.1%, 14.7%, 11.8% and 11.8% of the total, respectively. Conclusion Within our sample of paediatric patients, the rate of medication discrepancy and reconciliation errors at hospital admission was as relevant in terms of pharmacotherapy as has been reported in adults. The most frequent type of errors was omission of some home treatments. The main underlying disease with at least one error was neurological. As a whole, the detection of reconciliation errors in paediatrics by provision of medication reconciliation could be effective in reducing medication errors.

Keywords

Hospital admission Medication reconciliation Paediatrics Patient safety Spain 

Notes

Acknowledgements

The authors would like to thank all the pharmacists and members of the Pharmacy Service and Paediatricians from the hospital. They made this study feasible by their dedication to improving patient safety and safe practice in the healthcare chain. In addition, authors would like to thank all the paediatric patients and their caregivers for their great contribution to this study.

Funding

Supported by funding from the Pryconsa® Foundation (Madrid, Spain). The sponsor did not have any role in the design, methods, data collection, or analysis, and preparation of the manuscript.

Conflicts of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Servicio de FarmaciaHospital Infantil Universitario «Niño Jesús»MadridSpain
  2. 2.Departamento de Farmacología, Farmacognosia y Botánica, Facultad de FarmaciaUniversidad Complutense de MadridMadridSpain

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