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Article

Medicines Reconciliation in the Emergency Department: Important Prescribing Discrepancies between the Shared Medication Record and Patients’ Actual Use of Medication

1
The Capital Region Pharmacy, 2730 Herlev, Denmark
2
Emergency Department, Copenhagen University Hospital Amager and Hvidovre, 2650 Hvidovre, Denmark
3
Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, 2650 Hvidovre, Denmark
4
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
5
Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark
*
Author to whom correspondence should be addressed.
These authors share first authorship.
Academic Editors: Niels Westergaard, Charlotte Vermehren and Ziyaur Rahman
Pharmaceuticals 2022, 15(2), 142; https://doi.org/10.3390/ph15020142
Received: 9 December 2021 / Revised: 13 January 2022 / Accepted: 21 January 2022 / Published: 26 January 2022
Medication reconciliation is crucial to prevent medication errors. In Denmark, primary and secondary care physicians can prescribe medication in the same electronic prescribing system known as the Shared Medication Record (SMR). However, the SMR is not always updated by physicians, which can lead to discrepancies between the SMR and patients’ actual use of medication. These discrepancies may compromise patient safety upon admission to the emergency department (ED). Here, we investigated (a) the occurrence of discrepancies, (b) factors associated with discrepancies, and (c) the percentage of patients accessible to a clinical pharmacist during pharmacy working hours. The study included all patients age ≥ 18 years who were admitted to the Hvidovre Hospital ED on three consecutive days in June 2020. The clinical pharmacists performed medicines reconciliation to identify prescribing discrepancies. In total, 100 patients (52% male; median age 66.5 years) were included. The patients had a median of 10 [IQR 7–13] medications listed in the SMR and a median of two [IQR 1–3.25] discrepancies. Factors associated with increased rate of prescribing discrepancies were age < 65 years, time since last update of the SMR ≥ 115 days, and patients’ self-dispensing their medications. Eighty-four percent of patients were available for medicines reconciliations during the normal working hours of the clinical pharmacist. In conclusion, we found that discrepancies between the SMR and patients’ actual medication use upon admission to the ED are frequent, and we identified several risk factors associated with the increased rate of discrepancies. View Full-Text
Keywords: shared medication record; medication reconciliation; drug information service; hospital pharmacy service; electronic prescribing; electronic medical record; clinical pharmacist; emergency department shared medication record; medication reconciliation; drug information service; hospital pharmacy service; electronic prescribing; electronic medical record; clinical pharmacist; emergency department
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MDPI and ACS Style

Andersen, T.S.; Gemmer, M.N.; Sejberg, H.R.C.; Jørgensen, L.M.; Kallemose, T.; Andersen, O.; Iversen, E.; Houlind, M.B. Medicines Reconciliation in the Emergency Department: Important Prescribing Discrepancies between the Shared Medication Record and Patients’ Actual Use of Medication. Pharmaceuticals 2022, 15, 142. https://doi.org/10.3390/ph15020142

AMA Style

Andersen TS, Gemmer MN, Sejberg HRC, Jørgensen LM, Kallemose T, Andersen O, Iversen E, Houlind MB. Medicines Reconciliation in the Emergency Department: Important Prescribing Discrepancies between the Shared Medication Record and Patients’ Actual Use of Medication. Pharmaceuticals. 2022; 15(2):142. https://doi.org/10.3390/ph15020142

Chicago/Turabian Style

Andersen, Tanja Stenholdt, Mia Nimb Gemmer, Hayley Rose Constance Sejberg, Lillian Mørch Jørgensen, Thomas Kallemose, Ove Andersen, Esben Iversen, and Morten Baltzer Houlind. 2022. "Medicines Reconciliation in the Emergency Department: Important Prescribing Discrepancies between the Shared Medication Record and Patients’ Actual Use of Medication" Pharmaceuticals 15, no. 2: 142. https://doi.org/10.3390/ph15020142

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