Evaluasi Kejadian Diskrepansi Pada Pelaksanaan Rekonsiliasi Obat Di RSUD Bali Mandara

Authors

  • A.A.Ayunda Deva Rinata Universitas Bali Internasional
  • Ni Putu Aryati Suryaningsih Program Studi Farmasi Klinis, Universitas Bali Internasional
  • I Gusti Lanang Made Rudiartha Program Studi Farmasi Klinis, Universitas Bali Internasional
  • Ida Bagus Maharjana Program Studi Farmasi Klinis, Universitas Bali Internasional

Keywords:

Keywords: Medication discrepancies, medication reconciliation, patient transfer in hospital, medication reconciliation

Abstract

Background: Patients transfer is a vulnerable time during which patient are at high risk of experiencing discrepancies which can lead to medication errors and adverse drug events. In an effort to prevent discrepancies, the hospital applies pharmaceutical service called medication reconciliation which is carried out every time a patient transferred. The implementation of medication reconciliation for internal hospital patients transfer at Bali Mandara Hospital has only been implemented since April 2021. Purpose: This study aims to identify the incidence of discrepancies in patients transferred with and without medication reconciliation. Method: This observational study was conducted by taking patients medical record data and medication reconciliation forms who were transferred from the emergency departement to the inpatient ward (n = 96) on the period of August 2020-February 2022. To justify the identified discrepancies, validity of the study on the incidence of discrepancies was performed with clinical pharmacists. The number of differences in discrepancy in the two groups was compared using the Mann-Whitney U test with p-value≤0,05. Results: The results showed that 169 discrepancies were found in patients who were not reconciled. Meanwhile, 36 discrepancies were found too in patients who were reconciled. The effectiveness of the reconciliation process for internal hospital transfer had a significant value 0,000 (p<0,05). The most common category of discrepancies in both groups was omission (96,09%) followed by an inappropriate dose (3,03%). Conclusion: It can be conclude the number of discrepancies in patients without medication reconciliation was higher. There needs to be consistency in a structured and proactive medicaton reconciliation process during patient transfer in hospital.

References

Acheampong, F., Anto, B. and Koffuor, G., 2014. Medication safety strategies in hospitals – A systematic review. International Journal of Risk & Safety in Medicine, 26(3), pp.117-131.

Akram, F., Huggan, P., Lim, V., Huang, Y., Siddiqui, F., Assam, P. and Merchant, R., 2015. Medication discrepancies and associated risk factors identified among elderly patients discharged from a tertiary hospital in Singapore. Singapore Medical Journal, 56(07), pp.379-384.

Barnsteiner, J., 2005. Medication Reconciliation. AJN, American Journal of Nursing, 105(Supplement), pp.31-36.

Belda-Rustarazo, S., Cantero-Hinojosa, J., Salmeron-García, A., González-García, L., Cabeza-Barrera, J. and Galvez, J., 2015. Medication reconciliation at admission and discharge: an analysis of prevalence and associated risk factors. International Journal of Clinical Practice, 69(11), pp.1268-1274.

Buckley, M., Harinstein, L., Clark, K., Smithburger, P., Eckhardt, D., Alexander, E., Devabhakthuni, S., Westley, C., David, B. and Kane-Gill, S., 2013. Impact of a Clinical Pharmacy Admission Medication Reconciliation Program on Medication Errors in “High-Risk” Patients. Annals of Pharmacotherapy, 47(12), pp.1599-1610.

Boockvar, K., Carlson LaCorte, H., Giambanco, V., Fridman, B. and Siu, A., 2006. Medication reconciliation for reducing drug-discrepancy adverse events. The American Journal of Geriatric Pharmacotherapy, 4(3), pp.236-243.

Breuker, C., Macioce, V., Mura, T., Castet-Nicolas, A., Audurier, Y., Boegner, C., Jalabert, A., Villiet, M., Avignon, A. and Sultan, A., 2021. Medication Errors at Hospital Admission and Discharge: Risk Factors and Impact of Medication Reconciliation Process to Improve Healthcare. Journal of Patient Safety, 17(7), pp.e645-e652.

Chung, C., Gauthier, V., Marques-Tavares, F., Hindlet, P., Cohen, A., Fernandez, C. and Antignac, M., 2019. Medication reconciliation: Predictors of risk of unintentional medication discrepancies in the cardiology department. Archives of Cardiovascular Diseases, 112(2), pp.104-112.

Climente-Martí, M., García-Mañón, E., Artero-Mora, A. and Jiménez-Torres, N., 2010. Potential Risk of Medication Discrepancies and Reconciliation Errors at Admission and Discharge from an Inpatient Medical Service. Annals of Pharmacotherapy, 44(11), pp.1747-1754.

Cornu, P., Steurbaut, S., Leysen, T., Baere, E., Ligneel, C., Mets, T. and Dupont, A., 2012. Effect of Medication Reconciliation at Hospital Admission on Medication Discrepancies During Hospitalization and at Discharge for Geriatric Patients. Annals of Pharmacotherapy, 46(4), pp.484-494.

Curatolo, N., Gutermann, L., Devaquet, N., Roy, S. and Rieutord, A., 2014. Reducing medication errors at admission: 3 cycles to implement, improve and sustain medication reconciliation. International Journal of Clinical Pharmacy, 37(1), pp.113-120.

Dei Tos, M., Canova, C. and Dalla Zuanna, T., 2020. Evaluation of the medication reconciliation process and classification of discrepancies at hospital admission and discharge in Italy. International Journal of Clinical Pharmacy, 42(4), pp.1061-1072.

Departemen Kesehatan Republik Indonesia. 2016. Peraturan Menteri Kesehatan Republik Indonesia Nomor 72 tahun 2016 tentang Standar Pelayanan Kefarmasian di Rumah Sakit. Jakarta: Ditjen Bina Kefarmasian dan Alat Kesehatan Depkes RI.

Eisenhower, C., 2013. Impact of Pharmacist-Conducted Medication Reconciliation at Discharge on Readmissions of Elderly Patients With COPD. Annals of Pharmacotherapy, 48(2), pp.203-208.

Fernandes, O. 2009. Medication Reconciliation – Practical Tips, Strategies and Tools for Pharmacists. Pharmacy Practice 25(6), pp.24–32.

Galvin, M., Jago-Byrne, M., Fitzsimons, M. and Grimes, T., 2012. Clinical pharmacist’s contribution to medication reconciliation on admission to hospital in Ireland. International Journal of Clinical Pharmacy, 35(1), pp.14-21.

Kwan, J. L., Lo, L., Sampson, M., & Shojania, K. G. 2013. Medication reconciliation during transitions of care as a patient safety strategy: a systematic review. Annals of internal medicine, 158(5_Part_2), 397-403.

Lee, J., Leblanc, K., Fernandes, O., Huh, J., Wong, G., Hamandi, B., Lazar, N., Morra, D., Bajcar, J. and Harrison, J., 2010. Medication Reconciliation During Internal Hospital Transfer and Impact of Computerized Prescriber Order Entry. Annals of Pharmacotherapy, 44(12), pp.1887-1895.

Lemeshow, S., Hosmer, D.W., Klar, J & Lwanga, S.K. 1997. Besar sampel dalam penelitian kesehatan. Jogjakarta: Gajahmada University Press.

Lombardi, N., Mendes, A., Lucchetta, R., Reis, W., Fávero, M. and Correr, C., 2016. Analysis of the discrepancies identified during medication reconciliation on patient admission in cardiology units: a descriptive study. Revista Latino-Americana de Enfermagem, 24(0).

Marinović, I., Bačić Vrca, V., Samardžić, I., Marušić, S., Grgurević, I., Papić, I., Grgurević, D., Brkić, M., Jambrek, N. and Mesarić, J., 2021. Impact of an integrated medication reconciliation model led by a hospital clinical pharmacist on the reduction of post‐discharge unintentional discrepancies. Journal of Clinical Pharmacy and Therapeutics, 46(5), pp.1326-1333.

Poornima, P., Reshma, P., TV, R., Rani, N., G, S., Shree, R. and Seshadri, P., 2015. Medication Reconciliation and Medication Error Prevention in an Emergency Department of a Tertiary Care Hospital. Journal of Young Pharmacists, 7(3), pp.241-249.

Quélennec, B., Beretz, L., Paya, D., Blicklé, J., Gourieux, B., Andrès, E. and Michel, B., 2013. Potential clinical impact of medication discrepancies at hospital admission. European Journal of Internal Medicine, 24(6), pp.530-535.

Rozich, J., Howard, R., Justeson, J., Macken, P., Lindsay, M. and Resar, R., 2004. Standardization as a Mechanism to Improve Safety in Health Care. The Joint Commission Journal on Quality and Safety, 30(1), pp.5-14.

Salameh, L., Abu Farha, R., Abu Hammour, K. and Basheti, I., 2019. Impact of pharmacist's directed medication reconciliation on reducing medication discrepancies during transition of care in hospital setting. Journal of Pharmaceutical Health Services Research, 10(1), pp.149-156.

Sholihat, N. K., Hanifah, A., Puspaningtyas, M. D., Maharani, L., & Utami, E. D. 2018. Medication reconciliation as a tool to reduce medication discrepancy. Journal of Applied Pharmaceutical Science, 8(05), pp.115-118.

Sutema, I. A. M. P., & Maharjana, I. B. N. 2021. Pharmacist’s Role in Medication Reconciliation to Prevent the Risk of Medication Error at Bali Mandara Hospital. Journal of Pharmaceutical Science and Application, 3(1), pp.50-56.

Tamiru, A., Edessa, D., Sisay, M. and Mengistu, G., 2018. Magnitude and factors associated with medication discrepancies identified through medication reconciliation at care transitions of a tertiary hospital in eastern Ethiopia. BMC Research Notes, 11(1).

Urban, R., Armitage, G., Morgan, J., Marshall, K., Blenkinsopp, A. and Scally, A., 2014. Custom and practice: A multi-center study of medicines reconciliation following admission in four acute hospitals in the UK. Research in Social and Administrative Pharmacy, 10(2), pp.355-368.

Wong, J., Bajcar, J., Wong, G., Alibhai, S., Huh, J., Cesta, A., Pond, G. and Fernandes, O., 2008. Medication Reconciliation at Hospital Discharge: Evaluating Discrepancies. Annals of Pharmacotherapy, 42(10), pp.1373-1379.

Wortman, S., 2008. Medication reconciliation in a community, nonteaching hospital. American Journal of Health-System Pharmacy, 65(21), pp.2047-2054.

Published

2024-09-01