Accuracy in the medication history and reconciliation errors in the emergency department

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Currently&#44; medication errors &#40;MEs&#41; are a known cause of morbidity and mortality in healthcare<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">1&#44;2</span></a> and it is estimated that almost 40&#37; of adverse events &#40;AEs&#41; detected in Spanish hospitals may be related to the use of drugs&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">3</span></a> The study of ME over the last 2 decades has allowed identifying the care transition as one of the most risky points for these events&#46; Thus&#44; we know that up to 60&#37; MEs occur during the admission process&#44; inter-level transfers and at discharge&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Admission&#44; either programmed or through the emergency department&#44; is critical&#44; as it has been detected that discrepancies are frequent between chronic home medication and hospital prescriptions&#46; These discrepancies when they are involuntary and are not justified by clinical requirements can lead to negative consequences on the patient &#40;affecting both efficacy and safety&#41; and constitute the so-called reconciliation errors &#40;REs&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">As it usually happens in the case of MEs&#44; the causes of REs are multifactorial&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">5</span></a> However&#44; one major problem is the difficulty to obtain the list of the patient&#39;s home medication&#46; Currently there is no gold standard&#44; and various factors such as the lack of unified records in health care&#44; lack of access to medical records&#44; the use of different health systems &#40;private health care&#44; alternative medicine&#44; etc&#46;&#41; or ignorance from the patient about treatment&#44; greatly hinder the process&#46; An incomplete initial anamnesis makes it difficult for the diagnostic orientation of patient&#39;s symptomatology and may cause potential prescription errors during hospitalization&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">6</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Several studies on the quality of drug anamnesis estimate the percentage of histories with discrepancies range from 27 to 83&#37;&#44; depending on the type of drug&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">7</span></a> In the field of hospital emergency departments &#40;EDs&#41;&#44; it is estimated that 80&#8211;95&#37; of patients may be affected by some discrepancies in their drug histories&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">8&#8211;10</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Despite the growing number of studies in this field&#44; many of them have some limitations such as improper differentiation between the concepts of discrepancy in medical history and RE&#44; not verifying the medication list with the patient or not confirming with the attending physician the discrepancies detected&#46; In these cases&#44; it is difficult to understand the clinical relevance of the findings&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The purpose of this study is to obtain a qualitative and quantitative description of both processes &#40;recording home medication and reconciliation&#41; at the ED&#44; and how the presence of a clinical pharmacist can help detect and minimize such errors&#46; In addition&#44; factors associated with the occurrence of REs were assessed&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0035" class="elsevierStylePara elsevierViewall">Single-center&#44; prospective interventional study&#44; 4 month-duration &#40;November 2011&#8211;March 2012&#41; in the observation area of the emergency department of a tertiary care university hospital assisting about 90&#44;000 visitors a year&#46; In accordance with the ED operation&#44; the medication history is obtained by the doctor and can take place in 3 moments&#58; the first contact with the physician &#40;first visit&#41;&#44; after an initial assessment &#40;after-visit area&#41; or in the observation area&#46; This history should be recorded in the patient&#39;s medical records&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Adult patients aged over 18 were admitted to the observation area &#40;room for up to 28 patients&#44; where mainly&#44; but not only&#44; patients in the level III are referred to according to the Andorran Triage Model &#91;ATM&#93;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">11</span></a>&#41;&#46; They were assisted by ED physicians&#44; and were able to respond to interview questions &#40;or a family member or caregiver who could perform this function&#41; and agreed to participate in the study&#46; All patients who could not be interviewed because of language barriers or physical status &#40;e&#46;g&#46;&#44; disoriented or sedated patient&#41; were excluded&#46; Also&#44; all cases in which the detected discrepancies could not be verified by the physician in charge were excluded from the RE analysis&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Patients were recruited from Monday to Friday at 8&#46;00<span class="elsevierStyleHsp" style=""></span>am by a random selection&#46; The frequency of patients with medication history errors was expected to be 85&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">7&#44;10</span></a> To obtain a 5&#37; accuracy in estimating the ratio by a 95&#37; bilateral CI&#44; and with a 5&#37; loss&#44; it was calculated that 206 patients needed to be included&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The pharmacist interviewed all patients included&#44; using a standardized form in order to obtain the home medication list&#46; Home medication was defined as the medication a patient takes regularly at home&#44; including OTC drugs&#44; herbal products and alternative medicine&#46; Whenever possible&#44; the interview was based on a preliminary list of medications constructed from every source of information available &#40;medical history&#44; prescriptions&#44; medication lists or boxes provided by the patient&#44; discharge reports&#44; etc&#46;&#41;&#46; Subsequently&#44; this reference list was compared to&#58; &#40;1&#41; the patient&#39;s medical history previously recorded in the computer system &#40;evaluation of the medication history quality&#41;&#44; and &#40;2&#41; the medication prescribed during their stay in the ED &#40;evaluation of reconciliation&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">For evaluating reconciliation&#44; the consensus methodology provided by the Sociedad Espa&#241;ola de Farmacia Hospitalaria or SEFH &#40;Spanish Society of Hospital Pharmacy&#41;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">12</span></a> was followed&#46; The therapy prescribed for acute problem was always considered as justified discrepancy&#46; If any discrepancy not justified by the new clinical situation was detected&#44; this was discussed with the attending physician to determine if it was a RE&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Outcome variables were&#58; &#40;1&#41; percentage of discrepancies between medication recorded by the physician in the medical history and the list obtained by the pharmacist&#44; and &#40;2&#41; percentage of RE&#46; Discrepancy was defined as omission of&#44; or difference between&#44; the drugs&#44; dosage or route of administration&#46; REs were all unjustified discrepancies between the patient&#39;s home medication and the prescribed medication in the ED&#44; which after being discussed with the attending physician was modified or readjusted&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">12&#44;13</span></a> For the RE classification&#44; recommendations of the SEFH consensus document were followed&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">12</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">As additional variables&#44; data concerning the patient&#44; the reason for consultation and the reconciliation process were recorded&#58; sex&#44; age&#44; level of triage according to ATM&#44; polypharmacy &#40;&#8805;5 drugs regularly&#41;&#44; person in charge of medication &#40;patient&#44; caregiver&#44; residence&#41;&#44; grounds for visit&#44; interview timing and information sources used&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">For statistical analysis&#44; SPSS<span class="elsevierStyleSup">&#174;</span> statistical application &#40;v 15&#46;0&#41; &#40;SPSS Inc&#46;&#44; Chicago&#44; IL&#44; USA&#41; was used&#46; The qualitative variables were described as percentages&#44; and the quantitative variables as mean accompanied by its variability &#40;standard deviation &#91;SD&#93; or range&#41;&#46; Student <span class="elsevierStyleItalic">t</span>-test was used for comparing means&#44; and a univariate analysis was used to identify the variables associated with the presence of RE&#46; In all cases a 0&#46;05 significance level was used&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0075" class="elsevierStylePara elsevierViewall">During the study period 227 medication histories were conducted&#44; and 214 were eligible for analysis &#40;13 cases were excluded because of inability to verify the information with the attending physician&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The mean age of patients was 70 years &#40;range 18&#8211;102 years&#41;&#44; and 42&#37; were male&#46; 79&#37; patients were assigned to level III according to the ATM&#44; and 17&#37; to level II&#46; In over half the cases the patient was responsible for their own medication &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; The main reasons for visiting the ED were dyspnea &#40;35&#37;&#41;&#44; fever &#40;9&#37;&#41; and general discomfort &#40;6&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Almost half of the interviews &#40;45&#37;&#41; had some source of additional supporting information&#44; mainly&#58; electronic prescriptions &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>31&#41;&#44; residence&#47;social and health care reports &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>24&#41;&#44; reports on discharge &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#41; and reports from primary care &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#41;&#46; Boxes of medication and patients&#8217; own lists were obtained in 2 and 3&#37; of them&#44; respectively&#46; Mean time spent on the interview was 5&#46;38<span class="elsevierStyleHsp" style=""></span>min&#47;patient &#40;3&#46;34 SD&#59; range 1&#8211;35<span class="elsevierStyleHsp" style=""></span>min&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">The pharmacist identified 1474 regular prescriptions&#44; with a 6&#46;89 mean &#40;4&#46;43<span class="elsevierStyleHsp" style=""></span>SD&#41; drugs&#47;patient&#44; compared to the doctor&#44; who recorded 1220 drugs in total&#44; with a 5&#46;70 mean &#40;4&#46;53<span class="elsevierStyleHsp" style=""></span>SD&#41; drugs&#47;patient &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; A total of 1596 medication lines were verified and 980 discrepancies in medication histories were identified involving 85&#37; patients &#40;92&#37; if patients without home medication are excluded&#41;&#46; The average discrepancy per patient was 4&#46;58 &#40;4&#46;03<span class="elsevierStyleHsp" style=""></span>SD&#41;&#46; Only 39&#37; prescriptions recorded in medication history were correct as a whole&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">The main cause of discrepancy was the omission of treatment &#40;39&#37;&#41; or dosage &#40;33&#37;&#41; information&#46; The physician noted down in medication history 135 drugs that the patient was no longer taking &#40;drug commission&#41;&#46; In 3&#46;7&#37; cases the medication recorded was erroneous &#40;for example&#44; esomeprazole instead of pantoprazole&#41; and 10&#37; drugs written in the medical history were recorded at a wrong dosage &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">The reconciliation process was conducted on 197 patients taking medication regularly&#46; A total 1906 medication lines were reviewed&#44; most of which had no discrepancies compared to the prescribed treatment &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>485&#59; 25&#37;&#41;&#44; or these were justified by the patient&#39;s clinical condition &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1188&#59; 62&#37;&#41; and accounted for acute treatment scheduled in the ED&#44; mainly&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">In 233 cases the differences were not justified and required clarification from the physician&#46; In 157 cases &#40;68&#37;&#41; discrepancy was considered as RE&#44; involving nearly half of the sample &#40;43&#37;&#41;&#46; The mean error per patient was 0&#46;81 &#40;1&#46;17<span class="elsevierStyleHsp" style=""></span>SD&#41;&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The major causes of RE detected were the omission of a regular treatment to be maintained &#40;62&#37;&#41; and differences between scheduled dosage in the ED and the standard dosage &#40;16&#37;&#41;&#46; The 3 main pharmacological groups involved were&#58; cardiovascular system &#40;34&#37;&#41;&#59; nervous system &#40;21&#37;&#41;&#44; and those used in diseases of the digestive system and metabolism &#40;19&#37;&#41;&#46; Details of the RE types and the drugs involved are shown in <a class="elsevierStyleCrossRefs" href="#tbl0010">Tables 2 and 3</a>&#44; respectively&#46; In all groups&#44; the main type of RE was the omission of treatment&#44; consistent with the overall result&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">Finally&#44; the results of the univariate analysis identified age and polypharmacy as factors associated with the occurrence of REs&#44; while the presence of a caregiver or family responsible for the medication was associated with a lower risk&#46; Significantly more errors were found in patients providing any source of additional information&#46; The fact that the patient showed anamnesis errors was not identified as associated factor &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0120" class="elsevierStylePara elsevierViewall">The percentage of patients with discrepancies detected in their history records in this study was high &#40;85&#37;&#41;&#44; and stands at the top edge of rates reported by similar studies &#40;10&#8211;96&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">7</span></a> This high percentage of inaccuracies can be influenced by the definition of discrepancy used &#40;including assessment of both the drug and dosage&#41;&#44; because the analysis included OTC drugs and due to the demographic characteristics of the patients included&#46; Most patients were elderly&#44; with many pathologies and polypharmacy&#44; characteristics that may be associated with increased disease severity&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">14</span></a> Polypharmacy is also a major risk variable in ME&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">10&#44;15</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">The main cause of discrepancy was the omission of information on both the drug &#40;39&#37;&#41; and dosage &#40;33&#37;&#41;&#44; consistent with previous work&#44; although in some cases percentages differ from ours and may reach 61&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">8&#44;10&#44;16</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">Additionally&#44; the results of this study also show that the quality of the medication history varies depending on the professional involved in their production&#46; Therefore&#44; the pharmacist was able to identify a significantly higher number of drugs per patient than the physician&#46; Depending on the center&#44; the process to obtain the medication history can be performed by different professionals &#40;attending physicians&#44; residents&#44; nurses&#44; pharmacists&#44; pharmacy technicians&#41;&#44; with varying degrees of experience&#46; It would be desirable&#44; in future studies&#44; to analyze the characteristics of these professionals obtaining the best quality medication histories&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">In the case of pharmacists&#44; more time devoted to interviews&#44; the use of standardized forms and lower work load might be some of the reasons of the difference observed&#44; although the determination of these factors is beyond the scope of this study&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Regarding REs&#44; even though a large number of discrepancies between chronic medication and prescription in the ED were detected &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1421&#41;&#44; most of them were justified by the patient&#39;s clinical condition &#40;83&#46;6&#37;&#41;&#46; This factor is particularly relevant in an environment such as the ED&#44; where patient&#39;s acute condition is prevailing and can lead to necessary changes in their regular treatment&#46; A proper reconciliation does not necessarily imply to prescribe the full list of the home medication&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">17</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">In our study&#44; over half of the discrepancies were confirmed as REs and involved 43&#37; patients&#46; This value is comparable to the prevalence found by Cornish et al&#46; in a room of Internal Medicine&#44;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">18</span></a> but is significantly lower than the results obtained in 2 EDs in our environment&#44; in which REs were found in 71&#46;9 and 87&#37; patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">19&#44;20</span></a> In the second case&#44; the methodology does not explain whether or not the detected discrepancies need to be confirmed with the doctor&#44; and this might be one of the causes of the difference in the percentages obtained&#46; Another potential cause might be a lower acceptance rate of pharmacist interventions&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">As for characterizing the detected RE the omission of a regular patient&#39;s treatment that should be maintained is noted&#46; This is also the main type of error found in previous studies&#44; and has been identified as a potential cause of AE occurrence&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">18&#44;21&#44;22</span></a> There are little data on the type of drugs involved in the REs&#46; In our study&#44; the cardiovascular and central nervous system treatments were the most involved in REs&#44; consistent with the study by Cornish et al&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">18</span></a> The potential severity of detected REs is highly variable depending on the type of error and the active substance involved&#46; Abrupt discontinuation of many of the drugs detected during the study may cause withdrawal syndrome &#40;nitrates&#44; beta blockers&#44; calcium channel blockers&#44; antidepressants&#44; opioids&#44; antiparkinsonian agents&#44; etc&#46;&#41;&#44; dyskinesia and agitation &#40;antipsychotics&#41; and risk of bronchospasm &#40;tiotropium&#41;&#44; among other AEs&#46; However&#44; in the context of EDs&#44; the REs associated with statins and proton-pump inhibitors have very low potential to harm the patient&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">17</span></a> All REs were detected and understood early and none was harming the patient&#46; However&#44; previous studies have found that about 50&#37; of the AEs detected in the ED may be related to omission of regular treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">23</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">The analysis of the variables associated with REs offered some unexpected results&#46; The elderly and polypharmacy were identified&#44; predictably&#44; as factors associated with the occurrence of REs&#44;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">10</span></a> as well as the availability of additional sources of information&#46; One possible explanation is that the availability of these resources will facilitate the detection of potential REs&#44; not their appearance&#46; Additionally&#44; our study identified a potential &#8216;protection&#8217; factor&#58; a relative or caregiver is in charge of the medication&#46; We hypothesize that this parameter can be particularly important in patients with communication problems&#44; because of their advanced age or clinical condition&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Finally&#44; and unexpectedly&#44; no association between the discrepancies in the anamnesis and REs was found&#46; From our point of view this might be due to the high percentage of patients with discrepancies in the collection of medication data or the use of electronic information systems&#46; Despite the many benefits provided by these tools&#44; there is concern that they may be a source of new types of error due to system failures or incorrect use&#46; Improper use may lead to loss of relevant information and communication problems among professionals &#40;e&#46;g&#46;&#44; verbal changes in treatment that are not included in the history&#44; no start and end dates of prescriptions&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">24&#44;25</span></a> In addition&#44; several studies have begun to detect&#44; in institutions with electronic health records&#44; the so-called copy-paste phenomenon&#46;<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">26&#44;27</span></a> Physicians&#44; being aware of this problem which can influence the quality of information&#44; might not entirely rely on the data collected and choose to complete the information with other sources&#46; However&#44; this is just a new hypothesis that should be confirmed in future studies specifically designed for this purpose&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Inevitably our work has some limitations&#46; The major limitation&#44; common to all the studies reviewed&#44; is the lack of a gold standard for obtaining the list of home medication&#46; In this study&#44; the reference was the list obtained from various sources and it was verified with the patient in an interview&#46; Therefore&#44; the sample was restricted to those individuals able to adequately answer certain questions&#44; which is not always possible in routine clinical practice&#46; Second&#44; the data collection was standardized&#44; carried out early in the morning &#40;not always before the first prescription&#41; only on weekdays and it only included one center&#46; Therefore&#44; the extrapolation of results should be undertaken with caution&#46; Finally&#44; our study did not include implementation&#44; systematically&#44; of any tools that would transmit the information to the next level of care&#44; so we cannot determine the impact of our intervention beyond the results obtained in the ED&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">However&#44; from our point of view&#44; one of the main strengths offered by our work is that it is the first study to evaluate simultaneously&#44; and on the same population&#44; both the quality of the medication history and the reconciliation process&#44; using a standardized methodology&#46; Additionally&#44; we believe that interviews with the patient and the attending physician enrich the information obtained&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">The use of home medication in the ED is complex and they frequently&#44; in the acute condition&#44; go to the background&#44; sometimes even being under the control of the patient&#46; However&#44; proper medication history can play a significant role in finding a diagnosis&#46; The results of our study show that both the collection of the medication history and the reconciliation process in the ED involve a large number of patients and can be improved&#46; It is therefore necessary to provide integrated access to various information systems&#44; and insist on the quality of the data contained in them&#46; These improvements also require the professionals to be more involved&#44; by implementing medication reconciliation programs conducted by multidisciplinary teams&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">The pharmacist can help obtain a medical history of quality and increase patient&#39;s safety in the ED identifying and intercepting potential REs&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">28</span></a> Their involvement might be particularly beneficial in high-risk groups&#46; Further studies are required aimed at evaluating the impact of training measures&#44; the development of electronic resources and determining the impact of reconciliation in the ED over the next care transition&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Funding</span><p id="par0190" class="elsevierStylePara elsevierViewall">The completion of this work has been funded with the Emili Letang end-of-residency award&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflict of interest</span><p id="par0185" class="elsevierStylePara elsevierViewall">The authors report no conflict of interest regarding the contents of this article&#46;</p></span></span>"
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            4 => "Discrepancies"
            5 => "Emergency department"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec638078"
          "palabras" => array:6 [
            0 => "Conciliaci&#243;n"
            1 => "Historia farmacoterap&#233;utica"
            2 => "Seguridad del paciente"
            3 => "Error de medicaci&#243;n"
            4 => "Discrepancias"
            5 => "Urgencias"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background and objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To assess the accuracy of pharmaceutical anamnesis obtained at the Emergency Department &#40;ED&#41; of a tertiary referral hospital and to determine the prevalence of medication reconciliation errors &#40;RE&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This was a single-center&#44; prospective&#44; interventional study&#46; The home medication list obtained by a pharmacist was compared with the one recorded by a doctor to identify inaccuracies&#46; Subsequently&#44; the home medication list was compared with the active prescription at the ED&#46; All unexplained discrepancies were checked with the doctor in charge to evaluate if a RE has occurred&#46; A univariate analysis was performed to identify factors associated with RE&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The pharmacist identified a higher number of drugs than doctors &#40;6&#46;89 versus 5&#46;70&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; Only 39&#37; of the drugs obtained by doctors were properly written down in the patient&#39;s record&#46; The main cause of discrepancy was omission of information regarding the name of the drug &#40;39&#37;&#41; or its dosage &#40;33&#37;&#41;&#46; One hundred and fifty-seven RE were identified and they affected 85 patients &#40;43&#37;&#41;&#44; mainly related to information omission &#40;62&#37;&#41;&#46; Age and polymedication were identified as main risk factors of RE&#46; The presence of a caregiver or relative in the ED was judged to be a protective factor&#46; No relationship was found between inaccuracies in the registries and RE&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The process of obtaining a proper pharmaceutical anamnesis still needs improvement&#46; The pharmacist may play a role in the process of obtaining a good quality anamnesis and increase patient safety by detecting RE&#46; Better information systems are needed to avoid this type of incidents&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Background and objective"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Materials and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Fundamento y objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Evaluar la calidad de la historia farmacoterap&#233;utica registrada en un servicio de urgencias hospitalario &#40;SUH&#41; de un hospital de tercer nivel&#46; Determinar la prevalencia de errores de conciliaci&#243;n &#40;EC&#41;&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio unic&#233;ntrico&#44; prospectivo y de intervenci&#243;n&#46; Se compar&#243; la lista de medicaci&#243;n habitual obtenida por un farmac&#233;utico frente a la registrada por el m&#233;dico para identificar discrepancias&#46; Posteriormente&#44; se compar&#243; la medicaci&#243;n habitual con la prescripci&#243;n activa &#40;SUH&#41;&#46; Todas las discrepancias no justificadas se comentaron con el m&#233;dico para determinar si se trataba de un EC&#46; Se realiz&#243; un an&#225;lisis univariante para identificar factores asociados con la aparici&#243;n de EC&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El farmac&#233;utico identific&#243; un mayor n&#250;mero de f&#225;rmacos habituales por paciente respecto al m&#233;dico &#40;6&#44;89 frente a 5&#44;70&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; &#218;nicamente el 39&#37; de los f&#225;rmacos identificados por el m&#233;dico se registraron correctamente en la historia cl&#237;nica&#46; La principal causa de discrepancia fue la omisi&#243;n de informaci&#243;n a nivel de f&#225;rmaco &#40;39&#37;&#41; o de posolog&#237;a &#40;33&#37;&#41;&#46; Se detectaron 157 EC que afectaron a 85 pacientes &#40;43&#37;&#41;&#44; mayoritariamente por omisi&#243;n &#40;62&#37;&#41;&#46; Los principales factores asociados a EC fueron la edad y la polimedicaci&#243;n&#46; La presencia de un cuidador&#47;familiar responsable de la medicaci&#243;n fue un factor protector&#46; No se encontr&#243; asociaci&#243;n entre discrepancias en el registro y EC&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La recogida de la historia farmacoterap&#233;utica es un proceso susceptible de mejora&#46; El farmac&#233;utico puede ayudar a obtener una anamnesis de calidad e incrementar la seguridad del paciente interceptando EC&#46; Es necesario mejorar los sistemas de informaci&#243;n para evitar este tipo de incidentes&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Fundamento y objetivo"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Material y m&#233;todo"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; de Andr&#233;s-L&#225;zaro AM&#44; Sevilla-S&#225;nchez D&#44; Ortega-Romero MM&#44; Codina-Jan&#233; C&#44; Calder&#243;n-Hernanz B&#44; S&#225;nchez-S&#225;nchez M&#46; Adecuaci&#243;n de la historia farmacoterap&#233;utica y errores de conciliaci&#243;n en un servicio de urgencias&#46; Med Clin &#40;Barc&#41;&#46; 2015&#59;145&#58;288&#8211;293&#46;</p>"
      ]
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        "figura" => array:1 [
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        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Types of discrepancies detected between the physician&#39;s and pharmacist&#39;s medical history&#46;</p>"
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      1 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">SD&#58; standard deviation&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Male sex&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">90 &#40;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age in years&#44; mean &#40;SD&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">70 &#40;18&#46;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;65&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62 &#40;28&#46;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>65&#8211;80&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68 &#40;31&#46;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;80&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84 &#40;39&#46;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Level of triage&#44; n &#40;&#37;&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37 &#40;17&#46;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">169 &#40;78&#46;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;2&#46;80&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>V&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Polypharmacy patients &#40;&#8805;5 usual drugs&#41;&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">144 &#40;67&#46;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Patients with no home medication&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;7&#46;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Responsible of medication&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Patient&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">144 &#40;67&#46;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Caregiver&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47 &#40;21&#46;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Residency&#47;social-health&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;10&#46;75&#41;&nbsp;\t\t\t\t\t\t\n
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">According to the Andorran Triage Model&#46;</p>"
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          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">General characteristics of the study population &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>214&#41;&#46;</p>"
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        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">MG&#58; medication guidelines&#59; MH&#58; medical history&#59; ED&#58; hospital emergency department&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Type of reconciliation error&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Percentage &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Examples&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Omission of drug&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#46;42 &#40;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Omission of the regular treatment with paroxetine in elderly patient who complains of dyspnea&#46; Risk of withdrawal syndrome&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Discrepancy in dosage&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#46;92 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Patient with heart disease on a regular digoxin therapy scheduled inadvertently as twice his maintenance dose&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Drug not included in guidelines&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;73 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Torasemide prescription as part of antihypertensive therapy in a patient&#46; As it was not included in the MG&#44; it should have been replaced by another similar diuretic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Drug commission&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;10 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Combined prescription of citalopram and sertraline in the ED&#46; The patient had completed treatment with citalopram months ago&#46; The source of the error was a failure to update the MH &#40;both drugs were registered as regular treatment&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Different drug&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;10 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prescription of immediate release morphine instead of the sustained release morphine received by the patient regularly to control chronic pain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Incomplete prescription&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;10 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Incomplete command &#8220;pramipexole 1<span class="elsevierStyleHsp" style=""></span>c&#47;day&#46;&#8221; Tablets are available in different dosage&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Duplicity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;64 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Simultaneous prescription of inhaled tiotropium &#40;patient&#39;s regular treatment&#41; and nebulized ipratropium &#40;acute treatment initiated in the ED&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Types of reconciliation errors&#46;</p>"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">OAC&#58; oral anticoagulants&#59; ARA II&#58; angiotensin II receptor antagonists&#59; BPH&#58; benign prostatic hyperplasia&#59; PPI&#58; proton-pump inhibitor&#59; ACEI&#58; angiotensin-converting enzyme inhibitors&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pharmacological group&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Percentage &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Drugs involved&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cardiovascular system&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;39 &#40;54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Statins &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13&#41;&#59; ACEI &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#41;&#59; cardiac treatment &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8<span class="elsevierStyleHsp" style=""></span>&#44; nitrates&#44; digoxin&#44; etc&#46;&#41;&#59; calcium channel blockers &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#41;&#59; alpha-adrenergic antagonists &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#41;&#59; beta-blockers &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#41;&#59; ARA II &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#41;&#59; diuretics &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nervous system&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&#46;02 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Psychoanaleptics &#40;antidepressants&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#59; drugs for dementia&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41;&#59; psycholeptics &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#59; antipsychotics&#44; anxiolytics&#41;&#59; opioid analgesics &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#41;&#59; antiepileptics &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#41;&#59; antiparkinsonian &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Digestive system and metabolism&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;11 &#40;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PPI &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>19&#41;&#59; insulins &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#41;&#59; non-insulin antidiabetics &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#41;&#59; potassium &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Blood and hematopoietic organs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;46 &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Antiplatelet &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>11&#41;&#59; OAC &#40;acenocumarol&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#59; dabigatran n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&#59; folic acid &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hormonal therapy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;73 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Thyroid hormones &#40;levothyroxine&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#41;&#59; systemic corticosteroids &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&#59; antithyroid preparations &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Genitourinary therapy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;55 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Antiandrogens &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41;&#59; drugs for BPH &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Anti-infective therapy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;55 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Sulfonamides<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>trimethoprim &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41;&#59; fluoroquinolones &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&#59; reverse transcriptase inhibitors &#40;lamivudine&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Antineoplastic therapy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;91 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Calcineurin inhibitors &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41;&#59; Aromatase inhibitors &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Musculoskeletal system&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;64 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Antigout agents &#40;allopurinol&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Respiratory system&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;64 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Inhaled anticholinergics &#40;ipratropium n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Univariate analysis of factors associated with the occurrence of reconciliation errors&#46; Statistically significant variables were those whose 95&#37; confidence intervals do not contain value 1&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Patients with reconciliation errors&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Relative risk&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37; confidence interval&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Sex</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37 &#40;46&#46;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Reference&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48 &#40;41&#46;02&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;64&#8211;1&#46;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Age in years</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;29&#46;79&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Reference&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>65&#8211;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35 &#40;53&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;09&#8211;2&#46;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#8805;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36 &#40;42&#46;86&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;87&#8211;2&#46;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Regular therapy</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;5 drugs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;16&#46;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Reference&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#8805;5 drugs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76 &#40;52&#46;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;68&#8211;5&#46;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">In charge of medication</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Patient&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59 &#40;46&#46;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Reference&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Caregiver&#47;relative&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;27&#46;66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;36&#8211;0&#46;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Residency&#47;social-health&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;56&#46;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;81&#8211;1&#46;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Additional information source</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;33&#46;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Reference&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53 &#40;52&#46;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;12&#8211;2&#46;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Discrepancies in anamnesis</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Reference&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;35&#46;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;41&#8211;1&#46;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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