[Medication reconciliation at discharge in a psychogeriatric unit]

To analyze the impact of medication reconciliation at hospital discharge carried out by an interdisciplinary team on patients admitted to the psychogeriatric unit of a medium-stay hospital.

A quasi-experimental study comparing a historical control group (CG) (February-May 2023) with an intervention group (IG) from February to May 2024. Discrepancies were identified by a hospital pharmacist, and the resolution of the proposed interventions was recorded after being discussed with the geriatrician. Sociodemographic, clinical, pharmacological, and economic variables were collected.

58 patients were studied in the CG and 54 in the IG. 83 interventions were performed, 56 (67.5%) accepted. As a result, the median number of reconciliation errors per patient (IG Me: 0 [RIC: 0-1] vs. CG Me: 1 [RIC: 0-2]; p=0.024) and the percentage of patients with medication reconciliation errors at discharge decreased (CG 55.2% vs. IG 37%). Post-discharge, there was a significant mean difference in the Drug Burden Index (DBI) for the IG (2.00±0.69) compared to the CG (2.28±0.59) (p=0.023). In the IG, the number of chronic prescriptions decreased by 0.41 prescriptions (p=0.006), and the DBI was reduced by an average of 0.08 points (p=0.032). The intervention led to a 6.94% savings in treatment costs, amounting to an average of €8.34 per patient and month (95%CI: 3.09-13.59; p=0.002).

Medication reconciliation at discharge reduces medication reconciliation errors, the number of patients with medication reconciliation errors, chronic prescriptions and the DBI, resulting in an improvement in healthcare quality and cost savings.