Medication Reconciliation in the Surgical Setting: A Cross-Sectional Study in Polymedicated Patients

Area of Science:

• Pharmacology
• Patient Safety
• Surgical Care

Background:

• Polymedicated surgical patients are at high risk for medication errors.
• Perioperative medication management is complex and prone to discrepancies.
• Existing medication reconciliation processes may not adequately capture all discrepancies.

Purpose of the Study:

• To determine the incidence, nature, and clinical relevance of medication discrepancies in polymedicated surgical patients.
• To identify factors associated with real medication discrepancies.
• To evaluate the impact of these discrepancies on patient outcomes.

Main Methods:

• A cross-sectional study involving scheduled surgical patients taking ≥4 chronic medications.
• Medication reconciliation using electronic records and patient interviews.
• Classification of discrepancies as justified or real using SEFH criteria.

Main Results:

• 86% of analyzed medications had discrepancies, with 44% classified as real.
• An average of 5.7 real discrepancies per patient were identified.
• 36.8% of real discrepancies had potential clinical severity, affecting cardiovascular and nervous system drugs.

Conclusions:

• Frequent and clinically relevant medication discrepancies exist in polymedicated surgical patients.
• Current pre-anesthesia reports often lack specific medication management recommendations.
• Further research is needed to develop comprehensive perioperative safety strategies.