Communication between community and hospital pharm

Authors: Xavier Pourrat Hélène Corneau Stéphanie Floch Marie Pierre Kuzzay Luc Favard Philippe Rosset Nicolas Hay Jacqueline Grassin

Publish Date: 2013/05/18

Volume: 35, Issue: 4, Pages: 656-663

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Abstract

Objective To evaluate the nonintentional prescription discrepancies between home medication and hospital medication for inpatients their potential clinical impact and the impact of pharmaceutical communication between community pharmacists CP and hospital clinical pharmacists HCP to prevent them Setting Prospective study of 278 inpatient’s files hospitalized in orthopaedic surgery + units Methods After reconciliation by the HCP including patient interviews GP prescription reviews and CP drug delivery analyses we analysed patient files prescription and patient chart and we compared the administered drugs home medication to those that the patient should have received We tracked the pharmaceutical intervention the physician acceptance and the identified and avoided errors The clinical impact of each discrepancy was evaluated by a team composed of a physician and a clinical pharmacist Main outcome measure Frequency of intentional and nonintentional discrepancy NID evaluation of NID clinical impact and rate of NID identified and corrected by the reconciliation procedure Results 278 consecutive patients were included in the study 1532 prescription lines were analysed and 471 discrepancies were observed IC95  = 2843 3300 Nonintentional discrepancies NID affected 92  of prescription lines IC95  = 77 106 and 342  of patients IC95  = 313 371 Fiftyone patients 183  had at least one NID classified as potentially harmful Sixtynine percent of errors at admission were identified by the reconciliation procedure including data exchanges with CP Conclusion This study demonstrates the importance of drug reconciliation at patient’s admission by the HCP supported by communication with the CP

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