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

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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.

Original languageEnglish
Article number142
Issue number2
Number of pages13
Publication statusPublished - 2022

Bibliographical note

Funding Information:
Funding: M.B.H. was supported by a postdoctoral fellowship from The Capital Region’s Research Foundation for Health Research, Denmark (grant-A6882).

Funding Information:
M.B.H. was supported by a postdoctoral fellowship from The Capital Region?s Research Foundation for Health Research, Denmark (grant-A6882). Acknowledgments: This study was performed as part of the Clinical Academic Group (ACUTE-CAG) for Recovery Capacity nominated by the Greater Copenhagen Health Science Partners (GCHSP).

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.

    Research areas

  • Clinical pharmacist, Drug information service, Electronic medical record, Electronic prescribing, Emergency department, Hospital pharmacy service, Medication reconciliation, Shared medication record

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