CP-231 Implementation of medication reconciliation on admission in a psychiatric hospital: who comes first?

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BackgroundMedication reconciliation (MR) improves safety at transition of care. This time consuming process requires patient prioritising. MR in general hospitals focuses on patients ≥65 years old admitted via the emergency department (ED). No recommendation has been specifically elaborated for MR in psychiatric hospitals.PurposeTo identify patient selection criteria among psychiatric inpatients for MR on admission.Material and methodsA 6 week prospective monocentric study was conducted in a psychiatric hospital ward. The pharmacy resident acquired the best possible medical history for each admission, using all information sources available to identify treatments and check for allergies. The psychiatrist identified and corrected the medication errors (ME). Six patient selection criteria were investigated. Proportion and CI of patients presenting ME under each criterion were estimated and compared with that in the sample. The average medications prescribed on admission was compared between patients with and without ME using a unilateral Student test.Results45 patients were included, with a mean age of 51 years. 10 patients presented ≥1 ME (22%, CI 11.2–37.1). 21 ME were found (omissions=16, drug errors=2, dosage error=2, timing error=1). 6 ME were graded as significant or major. They involved anticoagulant, antihypertensive, antidiabetic and corticosteroid omissions. 15 were minor.CI overlap. Proportions of patients presenting ME under the above criteria did not significantly differ from that in the sample. Among patients without ME, the admission prescription listed on average 6.4 medications (min=5; max=15) whereas patients with ME had a mean of 8.8 medications prescribed (min=1; max=14). Admission prescription was significantly longer among patients with ME than patients without ME (p=0.038).ConclusionME did not appear to be related to sex, age ≥65 years, patient origin, admission type or period. But admission prescription was longer among patients presenting ME, even though most ME were omissions. The length of medication prescription on admission should be considered as a patient selection criterion for MR for psychiatric patients on admission.No conflict of interest

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