The medication discrepancy detection service: A cost-effective multidisciplinary clinical approach |
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Authors: | Ainhoa Oñatibia-Astibia Amaia Malet-Larrea Amaia Mendizabal Elena Valverde Belen Larrañaga Miguel Ángel Gastelurrutia Martín Ezcurra Leire Arbillaga Begoña Calvo Estibaliz Goyenechea |
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Affiliation: | 1. Official Pharmacist Association of Gipuzkoa, Prim 2, 20006 Donostia/San Sebastian, Spain;2. Pharmaceutical Technology Department, Faculty of Pharmacy, University of the Basque Country, UPV/EHU, P. Universidad 7, 01006 Vitoria, Spain;3. Primary Care Pharmacy, Bidasoa Integrated Healthcare Organisation (Osakidetza), Spain;4. Pharmaceutical Care Research Group, Faculty of Pharmacy, University of Granada, Campus Universitario de Cartuja, 18071 Granada, Spain;5. Martin Ezcurra Fernandez Pharmacy, Harmugarrieta 2, 20305 Irun, Spain |
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Abstract: | ObjectiveTo estimate the effectiveness of a Medication Discrepancy Detection Service (MDDS), a collaborative service between the community pharmacy and Primary Care.DesignNon-controlled before-and-after study.SettingBidasoa Integrated Healthcare Organisation, Gipuzkoa, Spain.ParticipantsThe service was provided by a multidisciplinary group of community pharmacists (CPs), general practitioners (GPs), and primary care pharmacists, to patients with discrepancies between their active medical charts and medicines that they were actually taking.OutcomesThe primary outcomes were the number of medicines, the type of discrepancy, and GPs’ decisions. Secondary outcomes were time spent by CPs, emergency department (ED) visits, hospital admissions, and costs.ResultsThe MDDS was provided to 143 patients, and GPs resolved discrepancies for 126 patients. CPs identified 259 discrepancies, among which the main one was patients not taking medicines listed on their active medical charts (66.7%, n = 152). The main GPs’ decision was to withdraw the treatment (54.8%, n = 125), which meant that the number of medicines per patient was reduced by 0.92 (9.12 ± 3.82 vs. 8.20 ± 3.81; p < .0001). The number of ED visits and hospital admissions per patient were reduced by 0.10 (0.61 ± .13 vs 0.52 ± 0.91; p = .405 and 0.17 (0.33 ± 0.66 vs. 0.16 ± 0.42; p = .007), respectively. The cost per patient was reduced by €444.9 (€1003.3 ± 2165.3 vs. €558.4 ± 1273.0; p = .018).ConclusionThe MDDS resulted in a reduction in the number of medicines per patients and number of hospital admissions, and the service was associated with affordable, cost-effective ratios. |
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Keywords: | Community pharmacy services Medication error Ambulatory care Error de medicación Servicios profesionales farmacéuticos comunitarios Atención primaria |
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