Document Type : Original Article
Authors
- . Thomas Croft Buck 1
- . Louise Smed Gronkjaer 1
- . Marie-Louise Duckert 1
- . Jens-Ulrik Rosholm 2
- . Lise Aagaard 3
1 Department of Clinical Pharmacy, Odense University Hospital Pharmacy, Odense, Denmark Department of Clinical Pharmacy, Hospitals Unit for Quality Assurance of Medicines Use, Odense University Hospital, Odense, Denmark
2 Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
3 Department of Clinical Pharmacy, Hospitals Unit for Quality Assurance of Medicines Use, Odense University Hospital, Odense, Denmark Clinical pharmacology, Institute of Public Health, University of Southern Denmark, Odense, Denmark
Abstract
Objective: Incomplete medication histories obtained on hospital admission are responsible
for more than 25% of prescribing errors. This study aimed to evaluate whether pharmacy
technicians can assist hospital physicians’ in obtaining medication histories by performing
medication reconciliation and prescribing reviews. A secondary aim was to evaluate whether
the interventions made by pharmacy technicians could reduce the time spent by the nurses
on administration of medications to the patients.
Methods: This observational study was conducted over a 7 week period in the geriatric
ward at Odense University Hospital, Denmark. Two pharmacy technicians conducted
medication reconciliation and prescribing reviews at the time of patients’ admission to the
ward. The reviews were conducted according to standard operating procedures developed
by a clinical pharmacist and approved by the Head of the Geriatric Department.
Findings: In total, 629 discrepancies were detected during the conducted medication
reconciliations, in average 3 for each patient. About 45% of the prescribing discrepancies
were accepted and corrected by the physicians. “Medication omission” was the most
frequently detected discrepancy (46% of total). During the prescribing reviews, a total of 860
prescription errors were detected, approximately one per medication review. Almost all of
the detected prescription errors were later accepted and/or corrected by the physicians.
“Dosage and time interval errors” were the most frequently detected error (48% of total).
The time used by nurses for administration of medicines was reduced in the study period.
Conclusion: This study suggests that pharmacy technicians can contribute to a substantial
reduction in medication discrepancies in acutely admitted patients by performing medication
reconciliation and focused medication reviews. Further randomized, controlled studies
including a larger number of patients are required to elucidate whether these observations
are of significance and of importance for securing patient safety.
Keywords
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