Pharmacoepidemiology of medications omitted in New Zealand Residential Aged Care Homes

Garratt, Stephanie M; Kerse, Ngaire; Peri, Kathy; Jonas, Monique; Scahil, Shane L.

doi:10.1111/ajag.12812

Cited by 5 publications

(8 citation statements)

References 15 publications

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“…Forty-eight percent of all medication omissions were recorded without a clinical note/rationale for the omission. This is explored in subsequent papers; it is unclear if these dose omissions are the result of clinical decision-making, medication unavailability, or whether these medication doses have been delayed, or simply not given [ 7 ].…”

Section: Resultsmentioning

confidence: 99%

“…Deviations from the guidelines occur, and may increase the risk of errors and adverse drug events [5]. Recording may not always reflect the reasons, clinical or otherwise, leading to an omission [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…This study aimed to quantify the incidence, prevalence, and categories of medication omission in RAC homes on a national-level, using a New Zealand database of electronic medication records (e-records). E-records are employed widely across New Zealand through medication systems such as Medi-Map™, which enable large-scale, de-identified, retrospective medication chart reviews [ 7 , 11 ]. At time of publication, approximately 70% of all RAC homes in New Zealand operated the Medi-Map™ system.…”

Section: Introductionmentioning

confidence: 99%

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Medication omission rates in New Zealand residential aged care homes: a national description

et al. 2020

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Background: A medication omission is an event where a prescribed medication is not taken before the next scheduled dose. Medication omissions are typically classed as errors within Residential Aged Care (RAC) homes, as they have the potential to lead to harm if poorly managed, but may also stem from good clinical decision-making. This study aimed to quantify the incidence, prevalence, and types of medication omissions in RAC homes on a national scale, using a New Zealand-based sample. Methods: We conducted retrospective pharmacoepidemiology of de-identified medication administration erecords from December 1st 2016 to December 31st 2017. Four tiers of de-identified data were collected: RAC home level data (ownership, levels of care), care staff level data (competency level/role), resident data (gender, age, level of care), and medication related data (omissions, categories of omissions, recorded reasons for omission). Data were analysed using SPSS version 24 and Microsoft Excel. Results: A total of 11, 015 residents from 374 RAC homes had active medication charts; 8020 resided in care over the entire sample timeframe. A mean rate of 3.59 medication doses were omitted per 100 (±7.43) dispensed doses/ resident. Seventy-three percent of residents had at least one dose omission. The most common omission category used was 'not-administered' (49.9%), followed by 'refused' (34.6%). The relationship between ownership type and mean rate of omission was significant (p = 0.002), corporate operated RAC homes had a slightly higher mean (3.73 versus 3.33), with greater variation. The most commonly omitted medications were Analgesics and Laxatives. Fortyeight percent of all dose omissions were recorded without a comment justifying the omission. Conclusions: This unique study is the first to report rate of medication omissions per RAC resident over a one-year timeframe. Although the proportion of medications omitted reported in this study is less than previously reported by hospital-based studies, there is a significant relationship between a resident's level of care, RAC home ownership types, and the rate of omission.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Medication omission rates in New Zealand residential aged care homes: a national description

et al. 2020

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“…Deviations from the guidelines occur, and may increase the risk of errors and adverse drug events [5]. Recording may not always re ect the reasons, clinical or otherwise, leading to an omission [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…This study aimed to quantify the incidence, prevalence, and categories of medication omission in RAC homes on a national-level, using a New Zealand database of electronic medication records (e-records). Erecords are employed widely across New Zealand through medication systems such as Medi-Map TM , which enable large-scale, de-identi ed, retrospective medication chart reviews [7,11]. At time of publication, approximately 70% of all RAC homes in New Zealand operated the Medi-Map TM system.…”

Section: Introductionmentioning

confidence: 99%

Medication omission rates in New Zealand Residential Aged Care Homes: a national description

Garratt

Kerse

Peri

et al. 2020

Preprint

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Background A medication omission is an event where a prescribed medication is not taken before the next scheduled dose. Medication omissions are typically classed as errors within Residential Aged Care (RAC) homes, as they have the potential to lead to harm if poorly managed, but may also stem from good clinical decision-making. This study aimed to quantify the incidence, prevalence, and types of medication omissions in RAC homes on a national scale, using a New Zealand-based sample. Methods We conducted retrospective pharmacoepidemiology of de-identified medication administration e-records from December 1st 2016 to December 31st 2017. Four tiers of de-identified data were collected: RAC home level data (ownership, levels of care), care staff level data (competency level/role), resident data (gender, age, level of care), and medication related data (omissions, categories of omissions, recorded reasons for omission). Data were analysed using SPSS version 24 and Microsoft Excel.Results A total of 11, 015 residents from 374 RAC homes had active medication charts; 8,020 resided in care over the entire sample timeframe. A mean rate of 3.59 medication doses were omitted per 100 (±7.43) dispensed doses/resident. Seventy-three percent of residents had at least one dose omission. The most common omission category used was ‘not-administered’ (49.9%), followed by ‘refused’ (34.6%). The relationship between ownership type and mean rate of omission was significant (p=0.002), corporate operated RAC homes had a slightly higher mean (3.73 versus 3.33), with greater variation. The most commonly omitted medications were Analgesics and Laxatives. Forty-eight percent of all dose omissions were recorded without a comment justifying the omission. Conclusions This unique study is the first to report rate of medication omissions per RAC resident over a one-year timeframe. Although the proportion of medications omitted reported in this study is less than previously reported by hospital-based studies, there is a significant relationship between a resident’s level of care, RAC home ownership types, and the rate of omission.

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A systematic review and meta-analysis of the dietary fiber menu provision and consumption for older adults living in residential care facilities

O'Brien,

Wilkinson,

Frampton

et al. 2024

The American Journal of Clinical Nutrition

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Pharmacoepidemiology of medications omitted in New Zealand Residential Aged Care Homes

Cited by 5 publications

References 15 publications

Medication omission rates in New Zealand residential aged care homes: a national description

Medication omission rates in New Zealand residential aged care homes: a national description

Medication omission rates in New Zealand Residential Aged Care Homes: a national description

A systematic review and meta-analysis of the dietary fiber menu provision and consumption for older adults living in residential care facilities

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