EAHP represents over 30,000 hospital pharmacists across 37 member countries. EAHP represents and develops the hospital pharmacy profession within Europe in order to ensure the continuous improvement of care and outcomes for patients in the hospital setting. This is achieved through science, research, education, practice, as well as sharing best-practice and responsibility with other healthcare professional
The EAHP Board, elected for three-year terms, oversees the association’s activities. Comprising directors responsible for core functions, it meets regularly to implement strategic goals. Supported by EAHP staff, the Board controls finances, coordinates congress organization, and ensures compliance with statutes and codes of conduct.
The EAHP staff supports the Board in executing EAHP’s mission. The Staff assists in financial management, events organisations, policy activities and all EAHP projects. The EAHP staff works closely with EAHP’s members and ensures the effective communication all relevant stakeholders.
The first member countries were Belgium, Britain, Denmark, France, the Federal Republic, Germany, Italy and The Netherlands in 1972. EAHP has now 36 EAHP members and 2 Associate Members. EAHP is open to countries members of the Council of Europe and since 2022 to organisations representing the interests of hospital pharmacists from outside the Council of Europe (Associate Membership)
EAHP’s structure is also composed by different standing committes: EAHP Scientific Committee, EAHP Education Executive Committee and the EAHP CTF Steering Committee.
At EAHP, we are committed to transparency in our governance, ethical standards, and funding practices. This section provides open access to our foundational documents, including the EAHP Statutes, Code of Conduct, and Funding Sources. By sharing these resources, we aim to uphold accountability and foster trust with our members, partners, and the public.
Keep up with all EAHP’s events and webinars. Contact the team at info@eahp.eu should you have any questions about upcoming events or activities.
Here you can find all upcoming events organised by EAHP and by all its members and associate members. Do not hesitate to contact the events team at events@eahp.eu should you have any questions about the organisation of these events.
Hospital pharmacists conduct a critical role in the care of patients in hospitals. Learn more about what they do here and in all the pages under Hospital Pharmacy practice and Policy.
Self-Assessment
SILCC
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EAHP brings together experts from many areas of hospital pharmacy practice providing and highlighting good local sustainable practices as that can be up-scaled and shared with other countries. The EAHP Working Group on Sustainability has the aim of reducing the environmental burden of the hospital pharmacy services.
The European Association of Hospital Pharmacists (EAHP), and its 36 member country platforms are creating a Common Training Framework for the hospital pharmacy education in Europe. The goal of this project is to allow the free movement of hospital pharmacists within the European Union.
The European Association of Hospital Pharmacists (EAHP) and the European Society of Clinical Pharmacy (ESCP) have collaboratively developed the Oath to Society. The Oath to Society is all encompassing and acts as a contract for excellence in providing compassionate patient care, working as part of the healthcare team and advancing the pharmacy profession, and showcasing how clinical and hospital pharmacists work every day
A day created to highlight the importance and to celebrate the work done by hospital pharmacies. This day celebrates all hospital pharmacy teams.
The Early Career Network aims to empower early-career pharmacists by sharing opportunities, insights, and success stories from across 25 member countries.
Together, we’re building a stronger, more connected hospital pharmacy community: one story, one country, one pharmacist at a time.
Catch up with EAHP’s press releases
Find all EAHP relevant publication like the EAHP Surveys, annual reports and the history books.
The European Journal of Hospital Pharmacy (EJHP) is the only official journal of the European Association of Hospital Pharmacists (EAHP) and is committed to advancing the science, practice and profession of hospital pharmacy. As the premier communication platform for hospital pharmacists worldwide, EJHP is a major source for continuing education as well as updates on advances in the practice and standard of pharmaceutical care for patients.
When EAHP and Hospital pharmacists appear in the news.
EAHP publishes a monthly EU monitor with updates about the latest EAHP initiatives and information relevant for the hospital pharmacy profession.
The Sponsor Channel is designed to maximise visibility and engagement, allowing sponsors to connect with the hospital pharmacy community and partners in a dynamic and interactive environment. From product demonstrations to networking sessions, the Sponsor Channel offers a range of opportunities for sponsors to showcase their offerings and generate leads in the new EAHP Website.
Production and Compounding
Esperanza Nieto Mártil
Alicia Abril Cabero
José Antonio Hernández Ramos
Isabel García López
Belén Riva de la Hoz
Esther Algarra Sánchez
Luis Fernández Romero
Marta Echávarri de Miguel
Beatriz Leal Pino
Alejandra Merino Pardo
Maite Pozas del Río
Paediatric PN requires highly precise and methodical preparation due to its narrow safety margins. For this population very small volumes are handled, thus small deviations in added volumes might have a substantial impact, including clinically significant consequences.
Although gravimetric and volumetric control has shown to provide a rapid and cost-saving tool to detect discrepancies, there are no specific publications evaluating its optimality in the context of paediatric PN. Therefore, its assessment in a paediatric setting is essential to ensure the quality of the compounding process.
To analyze the results of gravimetric and volumetric control applied to parenteral nutrition (PN) preparations compounded by the Pharmacy Department in a Paediatric Hospital over a two-month period.
A prospective interventional study was conducted including all PN preparations compounded between June and July 2025 in a tertiary paediatric hospital. In order to perform gravimetric control, actual weight of each PN and deviation from theoretical weight were measured. For volumetric control, prescribed volumes of each component were compared with the actual volumes added by compounders to verify concordance between both records. Additionally, the following variables were collected for every preparation: responsible compounder and the need for re-compounding. Erroneous preparations were defined as exceeding an acceptance limit of ±5% for gravimetric control or proven discrepancies for volumetric control.
A total of 135 PN preparations were compounded during the study period. Six preparations (4.44%) produced by three different compounders were classified as erroneous. Of these, five (3.70%) were associated to gravimetric control and one (0.74%) to volumetric control. All the preparations failing gravimetric control were re-compounded and their deviation range was 5.32% to 18.2%, with a median of 6.95%. The remaining erroneous preparation was found to lack 10 mL of a 10% amino acid solution, re-compounding was not required since it was considered clinically irrelevant though.
The incorporation of gravimetric and volumetric control into routine practice would gather strength as an essential safety measure in the preparation of pediatric PN due to its feasibility and utility, specially for gravimetry. Future lines of research should focus on continuous monitoring of outcomes, including comparisons with other hospitals.
Patient Safety and Quality Assurance
M. Echávarri de Miguel, C. Varela Guisasola, A. Sánchez Alonso, A. Abril Cabero, E. Nieto Martil, A. Merino Pardo, E. Algarra Sánchez, B. Riva de la Hoz, B. Márquez Arce, B. Leal Pino, M. Pozas del Río
Lactose used as a pharmaceutical excipient is generally obtained from skimmed milk and purified to remove milk proteins. Pharmacopoeias specify that lactose must be free from protein contaminants; hence, it has been considered safe for patients with cow’s milk protein allergy (CMPA). However, in severe allergies, medicines containing natural lactose should be avoided due to the potential risk of protein contamination. Although rare, cases of anaphylaxis from contaminant milk proteins have been reported, particularly with dry-powder inhalers, injectables, and vaccines.
This initiative arose after a suspected allergic reaction in a patient with severe CMPA following administration of an injectable containing lactose as an excipient. Given limited evidence and lack of transparency about lactose origin, an internal guideline was developed to enhance patient safety.
An internal hospital guideline was developed and implemented to verify the origin—natural or synthetic—of lactose used as an excipient in medicines. The guideline was created through systematic screening assisted by artificial intelligence, followed by verification with manufacturers.
With ChatGPT support, a Python-based code was created to analyze 3,278 pharmaceutical specialties for the presence of lactose. Manual validation of 360 medicines (95% confidence level, ±5% margin of error) confirmed the method’s reliability. The most dispensed medicines and all intravenous formulations, vaccines, and inhalers were reviewed due to higher risk described in literature. Manufacturers were contacted to determine whether lactose was natural or synthetic. Main challenges included delayed responses and limited data due to confidentiality.
Of the 3,278 medicines analyzed, 350 contained lactose or mentioned it in their product information, 1,522 did not, and 1,406 were inactive codes. Lactose origin was investigated for 152 products from 58 manufacturers, with responses in 92 cases (60.5%). Only five (5.4%) contained synthetic lactose. High-risk medicines included one inhaler and eight injectables (two vaccines) with natural lactose. Manual validation showed 100% concordance with automated results.
Next steps include expanding data to over 350 confirmed medicines, publishing results for open access, and developing an app for healthcare professionals. Integration into prescribing and dispensing systems is planned to generate automatic alerts for patients with severe CMPA.
Production and Compounding
A. Sousa; B. Martins; J. Gonçalves
ULSGE, Unidade Local de Saúde Gaia e Espinho, Vila Nova de Gaia, Portugal
ana.luisa.sousa@ulsge.min-saude.pt
The quality and effectiveness of surface cleaning in the Clinical Compounding Unit (CCU) directly impacts the quality and safety of compounded medications. As a routine task, cleaning is often undervalued, and its effectiveness uncertain. The need for a reliable, real-time monitoring method led to the implementation of ATP testing, ensuring cleaning processes are effective and reproducible. Standard operating procedures, work instructions, and audit tools were developed to support its integration, based on the hospital-wide protocol.
High ATP levels indicate poor cleaning performance and increased microbiological risk, enabling immediate corrective action before any clinical compounding takes place.
The “Hospital Cleaning Verification Procedure – ATP Bioluminescence Method”, developed by the Local Unit for Infection Prevention and Control and Antimicrobial Resistance (UL-PPCIRA), was adapted and implemented in the CCU of the Hospital Pharmacy Service.
The test is simple and can be performed by any trained healthcare professional. It involves swabbing a surface, followed by luminometric reading. The light intensity from the enzymatic bioluminescent reaction correlates with the amount of ATP, indicating organic contamination.
Key challenges included the time needed for staff training and initial resistance to procedural changes, with some perceiving the tests as personal performance evaluations. These were addressed through training sessions and awareness efforts focused on promoting a culture of quality and collective responsibility. At the end of the year, the test results will be presented to the team during a training session, as part of the annual training program.
Monthly internal testing and bimonthly external audits by UL-PPCIRA are conducted, with approximately 120 tests/year. Non-compliant results lead to immediate cleaning repetition. So far, 17% of tests exceeded acceptable ATP levels. The goal is to reduce this to 10% by year-end. The project has actively engaged a multidisciplinary team of pharmacists, pharmacy technicians, and support staff in improving service quality and patient safety through shared responsibility.
The aim is to maintain a dynamic, continuously improving process and expand ATP testing to other areas: Cytotoxic Preparation Unit, Repackaging Area, and eventually the entire Pharmacy Service. Future goals include identifying contamination sources to complement ATP testing, further enhancing process control.
Patient Safety and Quality Assurance
Dr. Tobias Leinweber1, Dr. Lukas Tometten2, Tobias Wingen1, Dr. Andrea Liekweg1, Prof. Dr. Norma Jung2
1 Hospital Pharmacy, University Hospital Cologne, Germany
2 Department I of Internal Medicine, Division of Infectious Diseases, University Hospital Cologne, Germany
Standardized dosing tables for anti-infective agents, specifically vancomycin and piperacillin/tazobactam, were developed and integrated into the electronic prescribing system (hospital information system – HIS) of the University Hospital Cologne. The tables provide evidence-based, renal function–adjusted dosing recommendations within the clinical workflow, supporting clinicians in accurate and safe prescribing.
Existing treatment standards for infectious diseases were often underutilized in daily practice due to limited accessibility and lack of integration into the electronic prescribing system/HIS. This led to dosing errors—particularly with vancomycin, where underdosing may cause therapeutic failure and overdosing toxicity. Additionally, EUCAST updates to piperacillin/tazobactam dosing required hospital-wide adaptation of practices. The initiative aimed to improve dosing accuracy, enhance antimicrobial therapy safety, and standardize prescribing practices through direct system integration.
The project was developed by an interdisciplinary team consisting of the Antimicrobial Stewardship (AMS) team, the Department of Infectious Diseases, and the hospital pharmacy. To ensure effective adoption and continuous improvement, a stepwise implementation approach was chosen, enabling feedback collection and iterative refinement. The rollout was supported by ward pharmacists who provided on-site guidance and assistance during initial implementation. Targeted training sessions and regular email communications informed and engaged prescribers. All relevant information was integrated into the hospital’s antibiotic guideline to ensure easy access and long-term consistency in clinical practice. Challenges such as differing user familiarity and workflow adjustments were addressed through ongoing training and direct support.
The implementation of the vancomycin dosing standard led to more consistent therapeutic drug monitoring (TDM), faster achievement of therapeutic levels, lower rates of toxicity, and reduced linezolid use, indicating improved prescribing behavior. The piperacillin/tazobactam dosing table was widely adopted, though further training remains necessary for full-scale use. Overall, the integration demonstrated improved medication safety, greater standardization, and enhanced clinical acceptance of the HIS-based prescribing system.
Training sessions, interdisciplinary experience exchange and interviews with clinicians are planned to ensure ongoing optimization.
This initiative illustrates how interprofessionally developed standards can be effectively embedded into clinical workflows. The approach can be easily transferred to other hospitals using similar prescribing software, offering a scalable model to strengthen antimicrobial stewardship, improve prescribing competence, and enhance patient safety.
Patient Safety and Quality Assurance
Furio Alessandro 5, Di Lorenzo Antonio 1, Noviello Chiara 4, Faggiano Maria Ernestina. 2, Bursomanno Beatrice 3, Cantalice Michele Alberto 5, Lobifaro Annamaria 5, Manicone Anna Lucia 5 , Spinelli Giuseppe 5, Parnoffi Nicoletta Francesca 5, Stefanizzi Pasquale 1, Tafuri Silvio 1
1 Dipartimento Interdisciplinare di Medicina – Università degli Studi di Bari Aldo Moro, Bari, Italia
2 Farmacia Ospedaliera – Azienda Ospedaliero Universitaria Policlinico di Bari, Bari, Italia
3 Scuola Di Specializzazione In Farmacia Ospedaliera – Università Degli Studi Di Bari Aldo Moro, Bari, Italia
4 Scuola Di Specializzazione In Igiene e Medicina Preventiva – Università Degli Studi Di Bari Aldo Moro, Bari, Italia
5 Unità di Programma Control Room / U.O.C. Igiene Universitaria – Azienda Ospedaliero Universitaria Policlinico di Bari, Bari, Italia
Hospitals face a significant challenge from healthcare-associated infections (HAIs), which stem from a complex interplay of various risk factors and have serious implications for patient safety and public health. The initiative was undertaken to address these threats through a multidisciplinary organizational framework, recognizing that safeguarding patients requires coordinated efforts from multiple healthcare professionals.
To tackle HAIs, the model implemented at Bari’s General Hospital combined systematic epidemiological surveillance with direct, onsite monitoring of healthcare practices, applying these strategies consistently using specifically designed checklists. This approach is fully in line with international recommendations, particularly the “One Health” strategy, which underscores the importance of integrated and multidisciplinary action in overcoming health challenges.
Prevalence studies, performed over a year, were recommended to improve understanding of infection risks related to invasive procedures, surgeries, and the use of antibiotics. These periodic surveys help to identify emerging trends and risk factors, enabling targeted interventions. Additionally, structured walkarounds within hospital facilities were implemented, allowing multidisciplinary teams to inspect environments, assess clinical records, and monitor drug storage methods. This approach not only prevents critical events but also highlights weaknesses and opportunities for improvement through focused staff training (audit).
Achievements from this combined strategy include a more integrated and thorough infection control program. By incorporating continuous audits, field surveillance, and ongoing education for healthcare staff, the hospital pharmacist’s role has evolved from being a background administrator to a frontline participant in infection prevention and stewardship. There has been a notable improvement in the management of both medications and medical devices, especially regarding their cleaning procedures and actual use. Additionally, significant progress has been made in the appropriateness of using anti-infective drugs—such as antifungals, antibiotics, disinfectants, and antivirals—resulting in more rational and safe pharmacological utilization throughout the hospital setting.
Further enhancements in infection control should focus on sustaining integrated surveillance, monitoring, and training programs. Moreover, it is essential to emphasize the importance of the hospital pharmacist within the corporate multidisciplinary team dedicated to the prevention of healthcare-associated infections, as their expertise is pivotal for the successful implementation of all strategic actions related to infection control and optimal medication use.
Patient Safety and Quality Assurance
S. Ambrosini, V. Orlando, C. Provezza Provezza, A. Zaltieri, N. Zanini, N. Faroni
Ensuring a multidisciplinary approach to the comprehensive care of hospitalized patients is a recognized indicator of healthcare quality. This strategy proved highly effective in the management of a patient with a multidrug-resistant Pseudomonas aeruginosa (PA) infection and a severe sacral pressure injury, requiring advanced antimicrobial therapy, targeted nutritional support, and specialized wound care to promote healing.
Multicompromised patients increasingly challenge hospital care due to infections from multidrug-resistant (MDR) bacteria, which limit therapeutic options and complicate management. Prolonged hospitalization also raises the risk of pressure injuries, worsening metabolic stress and delaying recovery. This initiative aim to apply an integrated therapeutic strategy—combining a reserve antibiotic, advanced wound care and tailored nutritional support—to promote healing, control infection and restore nutritional balance in a highly vulnerable patient.
The patient received Cefiderocol (2 g every 8 hours) and Fosfomycin (4 g every 6 hours) for six weeks to treat the PA infection. The pressure injury was managed with an oxygen-enriched oleic matrix dressing from organic olive oil, allowing controlled release of reactive oxygen species (ROS) to stimulate microcirculation, cell proliferation, and antimicrobial activity. Dressings were changed two to three times weekly based on progress. Nutritional needs were supported with a high-calorie, high-protein oral supplement (ONS) containing arginine, zinc, vitamin C, selenium, and carotenoids, given once or twice daily to enhance collagen synthesis and tissue repair.
This multidisciplinary strategy enabled the prompt definition and implementation of an optimal diagnostic–therapeutic pathway. The intervention and collaboration of multiple healthcare professionals ensured a faster and more effective patient response to treatment. The active involvement of the infectious disease specialist, clinical dietitian, wound care nurse, and hospital pharmacist guaranteed comprehensive, high-quality patient management —from drug and medical device supply to the successful resolution of infection and wound healing, while preventing malnutrition.
Establishing structured treatment pathways through multidisciplinary teams contributes to a more efficient and sustainable healthcare system. This experience represents an example of best practice, highlighting how collaboration among healthcare professionals—including pharmacists as medication safety officers—can be effectively translated to other hospital settings.
Patient Safety and Quality Assurance
C Gastalver Martin, O Serna Romero, I Escribano Valenciano, S Buendia Bravo, FJ Alonso Zazo, S Alvarez Atienza, D Garcia Gordillo, M Rubio Garcia, AM Iglesias Bolaños.
Medications prescribed in hospital’s electronic prescribing programs are transferred to automated dispensing devices (ADDs) to prevent medication errors and increase patient safety. This allows nurses to withdraw drugs from ADDs according to the medical prescription, dosage and schedule. However, most intensive care units (ICUs) have their own prescribing systems, usually computerized vital signs charts, which operate independently from the rest of the hospital systems. This fact could be a risk for patient safety.
The objective of this project is to increase the safety of patients admitted to ICUs by integrating prescriptions recorded in the computerized ICU chart with medication withdrawals from the ADD, thereby reducing medication errors.
A secondary objective was to automatically detect medications prescribed in the ICU but not entered into the unit’s ADD, improving medication availability without the need for manual review of the ICU prescription by the pharmacist.
This project increase the safety of patients admitted to the Intensive Care Unit by integrating prescriptions recorded in the automated ICU chart with medication withdrawals from the ADD.
This also permitted to detect automatically medications prescribed in the ICU but not available into the unit’s ADD, increasing medication availability without the need for manual review of the ICU prescription by the pharmacist.
This project was implemented in several phases:
1. Preparation Phase
a. Cleanup of the ICU chart medication database: review of standardized treatment lines, dose adjustments to medication presentations, and removal of duplicates.
b. Mapping of the medication database: assignment of the article codes contained in the ADD to the treatment lines in the ICU chart, so that both systems can communicate with each other.
2. Implementation Phase
a. Integration testing and troubleshooting.
b. Go-live.
The implementation of computer integration of medical prescriptions through automated dispensing devices increased patient safety and reduced medication errors.
It also decreased the need for manual review of the ICU prescription by the pharmacist to ensure medication availability in the ICU ADD.
Pharmaceutical validation of medical prescriptions for ICU patients remains essential to ensure the appropriate treatment of these patients
Patient Safety and Quality Assurance
Mengato D, Camuffo L, Todino F, Binanti ME, Sartori S, Benini F, Venturini F
Medication errors in pediatrics often arise from incorrect handling or administration by caregivers. Strengthening their knowledge is essential to improve safety and adherence. The initiative aimed to raise awareness and assess caregivers’ understanding of safe medication use, storage, and the role of compounded (“galenic”) medicines. It also intended to reinforce the visibility of clinical pharmacists as accessible medication experts for families.
On 17 September 2025, during the World Health Organization’s World Patient Safety Day themed “Safe care for every newborn and every child”, the clinical pharmacy team of the Azienda Ospedale–Università Padova organized an awareness event within the Pediatric Department. The initiative included a pharmacist-managed information desk, an interactive quiz for parents and caregivers, educational materials on safe medication practices, and gadgets for children to foster engagement. Pharmacists were available throughout the day to answer questions and provide individual counseling on pediatric medicines.
A voluntary anonymous quiz with 10 knowledge-based and 2 awareness questions was administered to parents visiting the department. Participants received a score (1–10) and tailored feedback: scores ≥8 indicated excellent knowledge, 5–7 good knowledge with room for improvement, and <5 the need for closer pharmacist or physician guidance. The event required coordination with pediatric staff and logistical support for educational materials and space allocation.
Thirty-two parents completed the quiz: 68.8% achieved ≥8 points (“super-pharma-parents”), 28.1% scored 5–7, and 3.1% scored <5. Knowledge was strong regarding shaking suspensions (100%), completing antibiotic courses (96.9%), and proper disposal of expired drugs (96.9%). Gaps emerged in measuring tools (9.4% incorrect) and preparation environment (6.2% unsuitable). Awareness of galenic medicines was limited (18.7% misdefinition). The initiative was well-received, stimulating high engagement and requests for future educational sessions.
The experience improved caregiver awareness and strengthened collaboration between families and clinical pharmacists. This initiative, which is embedded with the Clinical Pharmacy Ambulatory, represents a reproducible model to enhance pediatric medication safety. Future steps include integrating similar educational events into routine hospital activities and developing digital tools to extend pharmacist-led counseling to the community.
Patient Safety and Quality Assurance
Cruz Pardos, S. González Andrés, D. López San Román, MA
One of the standards established by the Joint Commission (JC) involves the identification of medications that may have risk to patients and/or be a potential source of error during its dispensation or administration. This includes look-alike/sound-alike (LASA) medications, high-risk medications (HRMs) defined by the Institute for Safe Medication Practices (ISMP), concentrated electrolytes, and hazardous drugs (HD) according to NIOSH classification.
A tag system was designed using color-coded stickers with specific text to identify each of the medication groups defined above:
• Red stickers with the statement “High risk medication” for HRMs.
• Red stickers with the statement “Dilute before administration” for concentrated electrolytes.
• Yellow stickers with the statement “Reproductive risk” or “Hazardous drug – handle with care” for HD.
• LASA medications: Red stickers were used for those that are also high-alert, while green stickers were applied to non-high-alert LASA drugs.
In addition, for medications requiring repackaging, the repackaging protocol was modified. The changes included:
• Labelling the medication profile with either HIGH-ALERT MEDICATION or HAZARDOUS DRUG.
• Using different photoprotective packaging paper: red for HRMs and yellow for HD
At first, two working protocols were developed:
1. Labelling protocol, detailing the characteristics of each type of sticker used to identify the different medication categories.
2. Repackaging protocol, ensuring proper identification of these medications during the repackaging process.
Secondly, lists of every category were compiled of the hospital’s available medications.
For LASA medications, brand names and images were included to improve differentiation and minimize errors.
• Identification of each medication according to their category at every stage of the medication use process: reception, storage, dispensing, and administration.
• Increased awareness among nursing staff regarding the safe and appropriate handling of these medications.
• The impact of these labelling project among all medicaments available in our hospital was: MAR: 18,6% , MP: 6,1% and LASA: 15,24%
• Develop a procurement protocol aimed at reducing the number of LASA medications.
• Raise awareness within the pharmaceutical industry about the importance of clearly differentiating pharmaceutical products.
• Automate the labelling process as much as possible, to avoid repetitive work.
Clinical Pharmacy Services
Mireia Coll-Vinent Ollé, Alba Martin Val, Lidia Estrada, Adrián Vilariño Seijas, Ana Cia Hidalgo, Marlene Álvarez Martins, Clara Rodríguez González, Júlia Galí Fortuny, Raquel Gil Bardají.
Care transitions are a major source of medication errors; therefore, therapeutic reconciliation plays an essential role in patient safety and treatment continuity. However, increasing workload and limited staff make it unfeasible to conduct thorough reconciliation for all patients systematically. The aim of this initiative was to develop a tool that enables prioritization of patients in therapeutic reconciliation and high-risk medication-related problems (MRPs) detection
A digital tool was developed and implemented to prioritize patients for therapeutic reconciliation at hospital admission and discharge. This approach allows hospital pharmacists to focus on patients with the greatest need for reconciliation, optimizing available resources and improving care continuity. The tool integrates structured clinical data from multiple sources: hospital and primary care records, electronic prescriptions, laboratory results, and nursing documentation.
A multidisciplinary team composed of clinical pharmacists and data engineers was established to design and implement the tool. Intelligent algorithms were developed to detect predefined alerts related to pathological history, inappropiate medication, anticholinergic burden, MRPs, drug–diagnosis and drug–parameter interactions, and drugs increasing fall risk. The tool was first validated through a pilot project, after which the algorithms were redefined based on preliminary results. Obstacles such as data integration from different systems, synchronization, and resource constraints were addressed by close collaboration with IT teams, and practical application of the tool.
The tool successfully reduced the time required for reconciliation by automatically prioritizing high-risk patients. It facilitated early detection of MRPs, leading to timely interventions and preventing potential adverse drug events. It also strengthened communication between hospitals, primary care, community pharmacies, and social-health centers, and supported health-care continuity.
This initiative represents a scalable model of good practice. It can be expanded to other hospitals and care settings where provided clinical data are structured and IT integration is feasible. Its adoption in broader healthcare contexts could optimize therapeutic reconciliation processes, reduce errors, and enhance patient safety across systems.
