FRI0727-HPR Implementation of a model for the medication reconciliation process in patients with rheumatoid arthritis

2018 
Background: Medication reconciliation is defined as ‘‘the process of identifying the most accurate list of all medications a patient is taking, including the name, dosage, frequency, and route of each medication, and using this list to provide the correct medications for the patient anywhere within the health care system”. It has been demonstrated that inadequate prescribing due to inaccurate medication histories and reconciliation can lead to medication errors, which have been associated with increased morbidity, mortality, and healthcare costs. Objectives: The aim of study was to design an intervention model leaded by pharmaceutical personnel in order to implement the reconciliation medication process in patients with RA in a specialized center. Methods: We included patients with RA; we analyzed their particular situation regarding their pharmacological therapy, dosage, frequency among others. Additionally, we applied checklists to find out about the pharmaceutical processes previously stablished in the RA center and applied a SWOT analysis (strengths, weaknesses, opportunities, and threats) to plan according to the needs diagnosis. Results: In our specialized RA center we found as strengths 1.the existence of analysis committee for the evaluation of patient’s therapy, 2. the open mind of the managers in order to implement the reconciliation process 3. The continued education opportunities that the health professionals receive in the specialized RA center. As weaknesses we found: 1.The absence of processes regarding the reconciliation process. 2. In the medical charts there was no registry of the chemical pharmaceutical professional procedures into the patient’s therapy. We performed 900 consultations as a pilot to implement the reconciliation medication process, as a result we found 73 patients with a clear need of medication reconciliation the reasons were therapeutic failure or adverse events related to medications. Probably attributed to the existence of multiple pathologies in 81% of patients. Regarding the pharmacological therapy 83% had a conventional DMARD primarily methotrexate in any pharmacological presentation, and biological therapy and, 12% had prescribed only biological DMARDs. Conclusions: With these results we will implement a new model where there will be a process to perform a medication reconciliation in patients with RA, we will review the medical charts in order to identify patients that have needs with the medication process interactions among others. Additionally, we will start new research projects in order to provide evidence of the usefulness of these types of interventions. References 1. Al-Rashoud I, Al-Ammari M, Al-Jadhey H, Alkatheri A, Poff G, Aldebasi T, et al. Medication discrepancies identified during medication reconciliation among medical patients at a tertiary care hospital. Saudi Pharmaceutical Journal: SPJ 2017;25(7):1082–5. 2. Kraus SK, Sen S, Murphy M, Pontiggia L. Impact of a pharmacy technician-centered medication reconciliation program on medication discrepancies and implementation of recommendations. Pharmacy Practice2017;15(2):901. Disclosure of Interest: None declared
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