4CPS-024 Implementation of a patient stratification method to prioritise medication reconciliation at admission in the emergency department

<h3>Background and Importance</h3> Medication reconciliation (MR) in the Emergency Service (ES) involves creating a complete list of a patient’s prior medications, comparing it to the current prescription, and resolving any discrepancies. <i>REDFASTER</i> group found that 79% of patients show medication discrepancies. Implementing a patient stratification system is essential to prioritise MR. <h3>Aim and Objectives</h3> To implement a patient stratification method to prioritise MR performed by the pharmacist at admission for patients in ES. To prioritise MR conducted by the pharmacist for target patients receiving high-risk medications (HRM). <h3>Material and Methods</h3> A stratification tool was created to prioritise MR for high-risk patients in the ES, using Microsoft Forms, scoring variables. <h3>Phases</h3> Form design (12/2023–01/2024). Inclusion of variables in the form: Age: ≥75 years (2 points), 65–74 years (1 point), &lt;65 years (0 points). Chronic treatment (CT), categorised by drug groups: Oral cytostatics, immunosuppressants, antiretrovirals, hospital-dispensed medications (5 points). Alpha-adrenergic agonists, oral anticoagulants, antiplatelets, antidepressants, anti-Parkinsonians, antiepileptics, antipsychotics, benzodiazepines, beta blockers, amiodarone/dronedarone or digoxin, corticosteroids &gt;3 months, opioids or non-steroidal anti-inflammatory drugs, diuretics, ocular and respiratory therapy (1 point). stratification levels: N1: Patients with 2 points for age and ≥5 points for CT. N2: Patients with ≥5 points for CT. N3: Patients with &lt;5 points for CT. The pharmacotherapy history of N1 patients is collected, and discrepancies are identified. Discrepancies are communicated and resolved with the responsible physician. <h3>Implementation</h3> After the form was developed, emergency pharmacists began performing patient stratification. To evaluate the activity over 10 days, RE were recorded across the three stratification levels. <h3>Results</h3> Se estratificaron 612 pacientes en total, con un promedio de 18,54 pacientes por día. La media de pacientes diarios por nivel de estratificación fue: N1 (2,84), N2 (1,48) y N3 (14,21). La distribución fue: N1: 15,36% (n=94). N2: 8,01% (n=49). N3: 76,63% (n=469). En total se produjeron 39 errores de ER en 83 pacientes. El número medio de errores por paciente en cada grupo fue: N1: 1,23 errores/paciente. N2: 0,50 errores/paciente. N3: 0,31 errores/paciente. La principal causa de error en todos los grupos fue la omisión. <h3>Conclusion and Relevance</h3> This method effectively streamlines medication reconciliation (MR) and is easily implementable for Pharmacy Services with electronic chronic medication records and an emergency department pharmacist. <h3>References and/or Acknowledgements</h3> REDFASTER Conciliación de los medicamentos en los servicios de urgencias SEFH, España. 2013;<b>25</b>:204–217. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://gruposdetrabajo.sefh.es/redfaster/documentos/conciliacion-de-los-medicamentos-en-los-servicios-de-urgencias_articulo.pdf <h3>Conflict of Interest</h3> No conflict of interest