MEDICATION RECONCILIATION IN THE CARE UNIT IN A PUBLIC HOSPITAL IN THE SOUTH OF BRAZIL

Abstract

One of the strategies used to improve the patient’s safety, mainly in identifying and preventing adverse events related to medicines, is  medication reconciliation. Identifying discrepancies between the drugs in use by the patient before hospital admission and the drugs prescription during  the hospitalization avoid damages that could be permanent, promoting the  patient’s safety. The study aimed to identify, through medication  reconciliation, discrepancies, and interactions on patients hospitalized in a  public hospital in the South of Brazil. A cross-sectional and descriptive study  was performed, based on patients’ interviews concerning the drugs in use  before the hospitalization and the drug prescriptions in the hospital. Most of  the patients were men, elderly, and with cardiovascular diseases as base  pathology. Out of 50 interviewees, 94% have presented at least one  discrepancy. Out of 153 discrepant drugs, 66.7% were classified as intentional discrepancies and 33.3% as non-intentional discrepancies. The  drugs impacting the cardiovascular system were the most frequent among  the discrepancies and possible drug interactions. This study portrays a significant number of discrepancies, whether intentional or not, after the  medication reconciliation. The patients with polypharmacy were the ones  who presented the highest number of possible drug interactions. Identifying  those discrepancies showed the importance of the demonstration of the medication reconciliation and the pharmacist intervention in the prevention  of adverse events related to drugs.