ENHANCING PATIENT SAFETY THROUGH THERAPEUTIC RECONCILIATION: LESSONS LEARNED FROM A CLINICAL IMPLEMENTATION

Abstract

Introduction: Therapeutic reconciliation aims to mitigate medication errors and adverse events by ensuring consistency in medication regimens during care transitions, thereby enhancing patient safety. This study conducted pilot research to assess the feasibility of implementing therapeutic reconciliation at hospital admission and identify resource requirements for its clinical practice.

Materials and Procedures: The pilot study involved 100 patients over 18 admitted to an internal medicine service between October and December of the previous year and receiving at least one chronic medication. A systematic approach was employed to gather the best possible pharmacotherapeutic history, identify discrepancies, categorize them, and implement resolutions.

Results: The study sample, with an average age of 77.04 years, predominantly comprised polymedicated individuals with multiple comorbidities. Seven hundred ninety-one disparities were identified, with intentional discrepancies accounting for 50.9% of cases. Challenges encountered included limited availability and quality of therapeutic information and difficulties in interprofessional communication. Priority resources were identified across process, tools, and personnel categories.

Conclusion: The study findings underscored deficiencies in clinical records at the interface between primary care and hospitals. Opportunities for optimization include prioritizing certain patient groups, standardizing and computerizing the reconciliation process, fostering multidisciplinary collaboration, and optimizing data sources. These insights offer valuable guidance for enhancing therapeutic reconciliation practices and improving patient safety during care transitions.