4CPS-136 Medication reconciliation in patients admitted to a neurology ward

<h3>Background and Importance</h3> Medication reconciliation has been shown to reduce unintentional medication discrepancies. Its role in neurology wards has not been widely studied. <h3>Aim and Objectives</h3> The aim of this study is to identify unintentional medication discrepancies by providing medication reconciliation in patients admitted to the neurology ward and to determine whether these discrepancies were possible adverse drug events. <h3>Material and Methods</h3> This prospective observational study was carried out between November 2023- March 2024 in the neurology ward of a tertiary care university hospital. Adult patients who were taking at least one prescription medication before hospitalisation were included. Admission medication reconciliation was performed within the first 24 hoursof the patient‘s admission to the ward(on mondays for patients admitted on weekends).Medication discrepancies were discussed with ward physicians to determine whether they were intentional or unintentional. The potential adverse drug events were assesssed by the study authors. <h3>Results</h3> 100 patients were included. 49.0% of patients were female. Median age 67.0(IQR:53.0–73.00). Median number of prescription medications prior to hospitalizaiton per patient was 5.0 (IQR: 3.0–7.0). 21 unintentional discrepancies were detected during admission medication reconciliation and 19 unintentional discrepancies were detected during discharge medication reconciliation. The number of patients with at least one unintentional medication discrepancy either at admission or at discharge was 24. Both at admission and at discharge,the most common type of unintentional medication discrepancy was the omisson of a medication (47.6% and 57.9% of unintentional discrepancies, respectively). Of the unintentional discrepancies at admission, 38.1% were considered as potential adverse drug events, while 10.5% were considered as potential adverse drug events at discharge. <h3>Conclusion and Relevance</h3> In the present study unintentional medication discrepancy rates comparable with other inpatient clinics were observed. And some of these unintentional medication discrepancies were assessed to be potential adverse drug events. This study is in line with previous publications, suggesting that neurology clinics might benefit from medication reconciliation provided by clinical pharmacists. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest