Assessment of the discrepancies identified in the elderlys medication conciliation at admission, transition and hospital discharge in a geriatric ward

Abstract

Goal: to assess the discrepancies detected in the conciliation of medications at the elderly's admission, transition, and hospital discharge in the geriatrics ward. Method: this is a cross-sectional, retrospective study with an analytical approach, which will be carried out in the geriatrics ward of the Hospital das Clínicas, Faculty of Medicine of Ribeirão Preto, University of São Paulo (HCFMRP-USP). The study will include the medical records of those individuals aged 60 years or older, of those who were hospitalized in the geriatrics ward from August 2021 to January 2022; and of those who were being followed up by pharmaceutical care and had been included in the medication conciliation service, consenting to participate in that study. The primary outcome of the research will be the discrepancies detected in medication conciliation and the variables that may be related to these events will be assessed (sociodemographic data; comorbidities and reason for hospitalization; the number of medications in use at admission and hospital discharge; sources selected as MHMP; medications associated with discrepancies; length of hospital stay, bed occupancy rate, and intra-hospital mortality rate). It will be calculated at the frequency for categorical variables and mean and standard deviation (SD) for continuous ones. Adjusted (multivariate) analyses will be performed and Pearson's correlation coefficient (r) will be used to report the association between the variables. The confidence interval will be standardized at 95% (CI 95%) and the significance level at 5%. Expected results: Scientific evidence is expected to demonstrate the medication conciliation service in a geriatric unit in Brazil, with the assessment of the discrepancies identified in medication prescriptions and the variables associated with these events. Furthermore, we aim to report the development of this action of pharmaceutical care in the hospital environment and establish the feasibility of replicating the service.(AU)