The Electronic Pharmaceutical Record: A new method for medication reconciliation

Jurado, Camille; Calmels, V.; Lobinet, Emilie; Divol, E.; Hanaire, H.; Metsu, David; Sallerin, Brigitte

doi:10.1111/jep.12942

Cited by 10 publications

(8 citation statements)

References 29 publications

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“…However, our results indicate that dosing discrepancies are common regardless of how a patient is referred to the ED. This suggests that relying solely on the SMR for a patient's medication history is unsafe, which is supported by several other studies [26][27][28][29]. A valid medication history should include at least two information sources with different perspectives (i.e., prescribing and dispensing) [5,13].…”

Section: Updating the Smr: Possible Solutions And Reflectionsmentioning

confidence: 81%

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

et al. 2022

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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.

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Section: Updating the Smr: Possible Solutions And Reflectionsmentioning

confidence: 81%

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

et al. 2022

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“…A study conducted in a hospital diabetes service in Toulouse, France, used the Electronic Pharmaceutical Record to summarize patients’ medication history, including over-the-counter drugs, dispensed by community pharmacies over the previous 4 months. 16 By using national health insurance card details and linking to a secure Electronic Pharmaceutical Record server, the study reported improved medication reconciliation accuracy. In almost 30% of patients, medication errors that had not previously been identified were able to be detected and rectified.…”

Section: Resultsmentioning

confidence: 96%

“…A number of studies (n = 26) described optimization strategies, implemented as single-component interventions (Table 2). 15–40 Table 2 summarizes the various single-component optimization strategies used in the included studies, highlighting the stage of the ePrescribing process being optimized and the overall reported effectiveness of the intervention on the primary outcome.…”

Section: Resultsmentioning

confidence: 99%

“…The healthcare context is also an important consideration for ePrescribing optimization strategies, with integrated healthcare systems aiding the detection of medication overuse, errors, and interactions. This is well illustrated by Jurado et al 16 who used integrated data from community pharmacies to help detect medication discrepancies on admission to hospital and also Weiner et al 88 who developed integrated information exchange between statewide emergency departments to counter opioid overuse. Conversely, nonintegrated healthcare systems will undoubtedly struggle to implement these optimization strategies.…”

Section: Discussionmentioning

confidence: 97%

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Optimizing Hospital Electronic Prescribing Systems: A Systematic Scoping Review

et al. 2022

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Objective: Considerable international investment in hospital electronic prescribing (ePrescribing) systems has been made, but despite this, it is proving difficult for most organizations to realize safety, quality, and efficiency gains in prescribing. The objective of this work was to develop policy-relevant insights into the optimization of hospital ePrescribing systems to maximize the benefits and minimize the risks of these expensive digital health infrastructures.Methods: We undertook a systematic scoping review of the literature by searching MEDLINE, Embase, and CINAHL databases. We searched for primary studies reporting on ePrescribing optimization strategies and independently screened and abstracted data until saturation was achieved. Findings were theoretically and thematically synthesized taking a medicine life-cycle perspective, incorporating consultative phases with domain experts.Results: We identified 23,609 potentially eligible studies from which 1367 satisfied our inclusion criteria. Thematic synthesis was conducted on a data set of 76 studies, of which 48 were based in the United States. Key approaches to optimization included the following: stakeholder engagement, system or process redesign, technological innovations, and education and training packages. Single-component interventions (n = 26) described technological optimization strategies focusing on a single, specific step in the prescribing process. Multicomponent interventions (n = 50) used a combination of optimization strategies, typically targeting multiple steps in the medicines management process.Discussion: We identified numerous optimization strategies for enhancing the performance of ePrescribing systems. Key considerations for ePrescribing optimization include meaningful stakeholder engagement to reconceptualize the service delivery model and implementing technological innovations with supporting training packages to simultaneously impact on different facets of the medicines management process.

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“…(Barakat & Franklin, 2020;Burkoski et al, 2019;Cabilan et al, 2017;González-Bueno et al, 2021;Kennedy & Massey, 2019;Küng et al, 2021;Mulac et al, 2021;Risør et al, 2017;Van Der Veen et al, 2018) Electronic Health System -HER Refs. (Amato et al, 2017;Biltoft & Finneman, 2018;Debono et al, 2017;Griffon et al, 2017;Jurado et al, 2018;Kirkendall et al, 2020;Pontefract et al, 2018;Reinhardt et al, 2019;Shah et al, ). In this case, it is necessary configuration by the doctor to input the cycles of the medication into the MBMS device first.…”

Section: Technologiesmentioning

confidence: 99%

Internet of Things as support to reduce hospital errors related to medication administration

Cocian¹,

Morales

Schneider

2023

RSD

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Objective: The high potential of digital technologies to reduce medication errors in patients hospitalized or under hospital care was explored in this investigation. The study identifies common types of medication errors and their probable causes. Furthermore, examines the technological innovation solutions available that have not yet been applied in this context, specifically the Internet of Things usage to reduce medication errors through a practical example. Methods: A rapid review was applied, exploring the papers from two databases. The analysis was limited to the period from 2017 to 2021, resulting in 147 articles from the VHL Regional Portal – Virtual Health Library and 257 articles from the PubMed database. Results: There were analyzed 40 studies. An error mapping related to the theme was made. Also, the technology application and their effectiveness were identified in the studies. According to the research, inattention or distraction due to the excessive journey of work was pointed out as the main reason that leads to medication errors with the systems employed. Conclusion: There are several opportunities to improve hospital procedures with new technological approaches. By implementing innovative technologies, hospital medication errors can be managed more efficiently and reduce costs and waste with errors medication.

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The Electronic Pharmaceutical Record: A new method for medication reconciliation

Abstract: This tool provided added value for reconciliation, as it quickly identifies regular medications, adherence, and self-medication behaviour. The ePR is essential for conducting a thorough MedRec.

Cited by 10 publications

References 29 publications

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

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

Optimizing Hospital Electronic Prescribing Systems: A Systematic Scoping Review

Internet of Things as support to reduce hospital errors related to medication administration

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