Paula Carneiro Ramalho*, Waleria de Paula, Lucas da Silva Braga, Andrea Grabe Guimaraes, Renata Cristina Rezende Macedo do Nascimento
Objective: To analyze (evaluate) the Medication Discrepancies (MD) in prescriptions of patients during a Medication Reconciliation (MR) service at admission to the Medical Unit.
Methods: A cross-sectional study was conducted from March 2021 to February 2022, in a medium-sized hospital of Minas Gerais state, Brazil. Patients aged 18 years or older and under continuous use of at least one medication at the moment of hospital admission were included. The first MR service interview was preferably conducted within 24 hours and should take place until 48 hours of admission. Socio-demographic data, health indicators, detailed information about home pharmacotherapy, and information of potential medication discrepancies were collected. The pharmaceutical care data and medical records were analysed using Stata 13.0 software. Pearson's Chi-square test was performed for the statistical analyses (significance 5%). The study was approved by the research ethics committee of the Universidade Federal de Ouro Preto (CEP)/UFOP under number 4.845.642.
Results: The majority of the 215 patients included were female (n=115; 53.5%), mean age of 68 ± 18 years, and patients aged ≥ 65 years (n=131; 61.0%) were prevalent. The mean number of medicines being used at the moment of hospital admission was 6 ± 3, and poly pharmacy was identified in 128 (59.5%) patients. The most prevalent comorbidities were diabetes mellitus and hypertension and the presence of at least one of these two comorbidities was observed in 80.0% of the patients (n=172). The variables age group (p=0.005), polypharmacy (p<0.001), having hypertension and/or diabetes mellitus (p=0.001), hospitalization for infectious and parasitic diseases (p<0.001) and circulatory system diseases (p=0.040) have a significant relation to the occurrence of at least one MD in prescriptions. Drugs used in diabetes mellitus (p<0.001), agents acting on the renin-angiotensin system (p=0.028), lipid-modifying agents (p=0.026), medications for obstructive airway diseases (p=0.001), general nutrients (p=0.005) and thyroid hormone medications (p=0.002) were associated with unintentional MD.
Conclusion: It was possible to identify a significant percentage of MD in the prescription evaluated. Poly pharmacy and age group were related to the occurrence of MD.
Published Date: 2025-01-23; Received Date: 2023-09-07
