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Infusions, Parenteral --- Drug Incompatibility --- Injections --- Drug Stability

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Infusions, Parenteral --- Injections --- Parenteral Nutrition --- Drug Stability --- Drug Incompatibility --- Solutions

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Incompatibles (Pharmacy) --- Drug stability --- Injections --- Solutions (Pharmacy) --- Handbooks, manuals, etc. --- Drug Incompatibility --- Drug Stability --- Infusions, Parenteral

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Background: Medication errors frequently occur in surgical patients. Prior studies suggest that prescribing errors are common, especially at the time of hospital admission and due to an incomplete drug history. A strategy for reducing medication discrepancies upon admission is medication reconciliation by hospital pharmacists in preadmission clinic. Objective: The aim of this study was to compare the drug histories acquired by an anesthetist and those obtained by a hospital pharmacist in preoperative clinic. If discrepancies were found, those were described and classified. A secondary objective was to assess the lime spent to solve prescribing problems due to incomplete drug histories at the dispensing sector of the hospital pharmacy .Methods: This prospective interventional study was conducted in a 300-bed hospital, from February to May 2016. During the pre-intervention period, patients received usual medical care of the anesthetist, who documented the medication history. The intervention consisted of the integration of a hospital pharmacist to the preadmission clinic to obtain the best possible medication history. The primary measure was the average number of discrepancies per patient. Results: After screening of 941 patients, 156 were included: 79 in the standard care arm and 77 in the intervention arm. In the standard care arm, the average number of discrepancies per patient was 9.9, compared with 1.8 in the intervention arm (p<0.01). All patients (100%) of control group had at least 1 medication discrepancy, compared with 53 patients (68.8%) in the intervention group. These were mostly "administration moment" discrepancies. Conclusions: Implementing a consultation by a hospital pharmacist in a preoperative clinic improves the medication reconciliation. These results suggest that drug histories obtained by a pharmacist may reduce potential adverse drug events due to medication discrepancies.

Medication Errors --- Preoperative Period --- Medical History Taking --- General Surgery --- Drug Incompatibility

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Drug Incompatibility --- Infusions, Parenteral --- Drug stability --- Incompatibles (Pharmacy) --- Injections --- Solutions (Pharmacy) --- Médicaments --- Solutions (Pharmacie) --- handbooks. --- Stabilité