Impact of a Prescription Review Program on the Accuracy and Safety of Discharge Prescriptions in a Pediatric Hospital Setting

Christiansen, Shannon Ryan; Morgan, Jill A.; Hilmas, Elora; Shepardson, Adrienne

doi:10.5863/1551-6776-13.4.226

Cited by 5 publications

(11 citation statements)

References 18 publications

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“…23 With respect to transitioning care to the community setting, a group of 15 hospitals enrolled patients in discharge prescription programs (DPPs) to combat medication non-adherence and avert re-hospitalization. 24 In addition to targeting PHS at the initial hospitalization, our findings suggest the need for surgeons to target PHS in the clinic when consulting patients pursuing elective surgical procedure.…”

Section: Discussionmentioning

confidence: 81%

Effect of Posthospital Syndrome on Health Care Utilization After Abdominal Contouring Surgery

Swiatek¹,

Johnson

Wang

et al. 2018

Ann Plast Surg

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Background: Post-hospital syndrome (PHS) is a transient condition after acute hospitalizations when patients are physiologically deconditioned. The objective of this study was to determine if having PHS at the time of abdominal contouring surgery increased the incidence of post-operative adverse medical events. Methods: We conducted a retrospective cohort study of patients enrolled in the MarketScan Databases who underwent outpatient functional or cosmetic abdominal contouring surgery (i.e. abdominoplasty, liposuction, or panniculectomy) from April 2010 to August 2015. Patients were separated into two groups based upon PHS exposure, defined by hospitalization within 90 days prior to surgery. Differential healthcare utilization within 30 days after surgery was compared between cohorts. Results: Among the 18,947 patients included in the final cohort, 1,045 patients (6%) had PHS at the time of abdominal contouring surgery. Patients with PHS experienced more emergency department visits (0.16 vs. 0.08 visits, adjusted odds ratio =1.60, p<0.001) and more episodes of hospitalization (0.11 vs. 0.04 episodes, AOR=1.70, p<0.001) within 30 days postoperatively. The mean unadjusted healthcare utilization following abdominal contouring surgery for patients with PHS was $7,888 (SD=17,659) versus $2,943 (SD=9,096) in patients without PHS. After controlling for confounders, such as comorbidity-burden, PHS was associated with $3,944 greater cost than patients without PHS (p<0.001). Conclusion: Among patients undergoing outpatient abdominal contouring surgery, having PHS increased the incidence of adverse medical events requiring medical attention in the 30-day post-operative period. These findings support the inclusion of PHS in pre-operative evaluation and preparation for patients seeking abdominal contouring surgery.

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Section: Discussionmentioning

confidence: 81%

Effect of Posthospital Syndrome on Health Care Utilization After Abdominal Contouring Surgery

Swiatek¹,

Johnson

Wang

et al. 2018

Ann Plast Surg

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“…Previous studies have evaluated discharge prescription review programs, but few have qualified the type of medications that children received. 7,[9][10][11] The majority (79%) from our study were discharged from a medical service, and 82.6% were discharged on a maintenance medication. The median (IQR) number of total discharge medications was 3 (2-6), but there was no difference in the overall net change of home medications stopped and new medications added at discharge.…”

Section: Discussionmentioning

confidence: 89%

“…Currently, our institution does not have a formal medication discharge prescription program (MDPP); other institutions have implemented a program and found positive effects on medication errors and cost-savings. 7,10,11 Most patients were discharged from a medical service, with the primary service being General Pediatrics (62.7%). During the study, there were four General Pediatrics teams, three were teaching teams and one staffed by pediatric attendings.…”

Section: Discussionmentioning

confidence: 99%

“…One recent study found that 80% of pediatric in-patient discharge prescriptions had >1 prescribing error. 7 Providers at most children's hospitals utilize computerized prescriber order entry (CPOE) systems to prescribe medications during the in-patient setting as well as at the time of hospital discharge. While CPOE has reduced the number of calculation errors for weight-based dosing in children, it may result in a different type of dosing error when unreasonable and unmeasurable doses are calculated (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…Currently, limited studies have evaluated the most common medications and prevalence of unrounded doses prescribed to children upon hospital discharge. 7,[9][10][11] One recent study noted that children with multiple maintenance medications had an increased number of medication discrepancies during transitions of care. 12 The purpose of this descriptive study was to quantify and describe discharge prescriptions in hospitalized children.…”

Section: Introductionmentioning

confidence: 99%

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Descriptive study of discharge medications in pediatric patients

et al. 2020

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Background: Limited studies have evaluated medications in children discharged from hospitals. Knowledge of the number of medications and dosage forms could provide a baseline to establish a medication discharge prescription program. Objectives: To identify the median number of discharge prescriptions per patient. Secondary objectives included an evaluation of the dosage formulations and frequency, and comparisons of the prevalence of unrounded medication doses between service type (medical vs surgical) and physician provider level (trainees vs attendings). Methods: This retrospective study included children <18 years receiving >1 discharge prescription during 4 selected months over a 1-year time frame. Comparisons were made via Pearson’s chi-square tests, Fisher’s Exact tests, and Kruskal–Wallis nonparametric rank tests as appropriate with a priori p value of <0.05. Results: A total of 852 patients were evaluated, with most (78.8%) on a medical service. The median (interquartile range) number of new medications at discharge was 2 (1–3), with the median total number of discharge medications of 3 (2–6). There was no difference in the net change of the median number of home medications stopped and new medications started between service types. The majority (72.2%) received >1 oral liquid medications. There was no difference in prescribing rates per service type and provider level. There was a difference in the number of unrounded doses between trainees versus attendings, 17.8% versus 9.5%, p = 0.048. Conclusion: Patients were discharged on a median of three medications, and most received >1 oral liquid medications. These data can be used to target children who would benefit from medication discharge prescription programs.

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Evaluating the Accuracy of Drug Dosing in the Prescriptions for Children under 5 Years Old from Non Pediatric Physicians in Outpatient Clinics

Mikhael¹

2014

AJPS

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Background: Pediatric patients are more vulnerable to the effects of a medication error and may experience a more serious adverse drug reaction than adults. Dosing errors represent the most common medication errors that occur in pediatric prescriptions. This study aimed to evaluate the accuracy of drug dosing that prescribed for children under 5 years by non paediatric specialist physicians in their outpatient clinic setting. Methods: An observational study was done in a single outpatient pharmacy located in Al-Amria at Baghdad/ Iraq from May to August 2014. 24 prescriptions to children less than 5 years old from non pediatric physicians were included in this study. Each prescription will be carefully examined to collect the following data: age and weight of the patient, diagnosis of the case, the name of the prescribed drugs with their strength, dose, route of administration and frequency of usage. All children were weighted in the pharmacy. Determination of the accuracy of drug dosing for each drug in all prescriptions was based mainly on drug dosing that stated in BNF for children. Results: The percent of correct dosing in the prescriptions of non pediatricians in their outpatient clinics to children below 5 years old is only 31%. Dosing error was more common (90%) in infants than in older children (64.5%). antibiotics were the most common class of drugs that prescribed to children, while the highest percent of dosing error was related to steroid, antipyretic and analgesic prescribing. Conclusion: Dosing error is a common problem in the Rx of non pediatrician in outpatient clinics for preschool children in general and for infants specially.

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Impact of a Prescription Review Program on the Accuracy and Safety of Discharge Prescriptions in a Pediatric Hospital Setting

Cited by 5 publications

References 18 publications

Effect of Posthospital Syndrome on Health Care Utilization After Abdominal Contouring Surgery

Effect of Posthospital Syndrome on Health Care Utilization After Abdominal Contouring Surgery

Descriptive study of discharge medications in pediatric patients

Evaluating the Accuracy of Drug Dosing in the Prescriptions for Children under 5 Years Old from Non Pediatric Physicians in Outpatient Clinics

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