Objective: Assess the main pharmacologic discrepancies of prescription in a Hospital, after 48 hours of the admission to the Emergency Department, to improve the care assistance service. Method: A descriptive, observational, prospective study was performed. A medication list of taken home drugs was compiled and compared with the collected data in prescription between the first 48 hours after the patient admission in the Emergency Department. Moreover, prioritization of remitted patients to critical care and hospitalization units was done. For the validation of the obtained data, it was developed a pilot plan during the months of March and April of 2016, classifying drugs in three categories according to their risk degree. Results: A total of 125 patients were included while 165 discrepancies were found during the first 48 hours of care (Z90%=1, 64 ; e=4, 4%). It was found that 23, 6% were justified, 22, 6% were not discrepancies and 53. 9% were not justified discrepancies. The drugs most related with not justified discrepancies were hypoglycemic agents (29%), antihypertensive agents (27%) and lipid-lowering agents (28%). They were distributed in B1: medication omission (29. 7%); B2: start of medication-commission (4. 80%) and B3: lack of route, dose or frequency (19. 4%). Acceptance by emergency physicians on the reconciliation interventions were: category 1 (81%), category 2 (52%) y category 3 (73%). Conclusions: The pilot plan of medication reconciliation has allowed identifying potential medication mistakes in patients, who benefited of optimizing pharmacotherapy interventions.
