Prevention of medication errors at hospital admission: a single-centre experience in elderly admitted to internal medicine

Mazhar, Faizan; Haider, Nafis; Al-Osaimi, Yousif Ahmed; Ahmed, Rafeeque; Akram, Shahzad; Carnovale, Carla

doi:10.1007/s11096-018-0737-2

Cited by 19 publications

(23 citation statements)

References 24 publications

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“…In addition, despite our monocentric design, our population seems to be representative of an internal medicine unit population with chronic diseases, a large number of treatments and an advanced age. Our population also included a large proportion of admissions from emergency unit and during the night or weekend as described in many studies 15,31,32 …”

Section: Discussionmentioning

confidence: 99%

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Development and validation of a score to assess risk of medication errors detected during medication reconciliation process at admission in internal medicine unit: SCOREM study

et al. 2020

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Background Medication errors (ME) can be reduced through preventive strategies such as medication reconciliation. Such strategies are often limited by human resources and need targeting high risk patients. Aims To develop a score to identify patients at risk of ME detected during medication reconciliation in a specific population from internal medicine unit. Methods Prospective observational study conducted in an internal medicine unit of a French University Hospital from 2012 to 2016. Adult hospitalised patients were eligible for inclusion. Medication reconciliation was conducted by a pharmacist and consisted in comparing medication history with admission prescription to identify MEs. Risk factors of MEs were analysed using multivariate stepwise logistic regression model. A risk score was constructed using the split‐sample approach. The split was done at random (using a fixed seed) to define a development data set (N = 1256) and a validation sample (N = 628). A regression coefficient‐base scoring system was used adopting the beta‐Sullivan approach (Sullivan's scoring). Results Pharmacists detected 740 MEs in 368/1884 (19.5%) patients related to medication reconciliation. Female gender, number of treatments >7, admission from emergency department and during night or weekend were significantly associated with a higher risk of MEs. Risk score was constructed by attributing 1 or 2 points to these variables. Patients with a score ≥3 (OR [95% CI] 3.10 [1.15‐8.37]) out of 5 (OR [95% CI] 8.11 [2.89‐22.78]) were considered at high risk of MEs. Conclusions Risk factors identified in our study may help prioritising patients admitted in internal medicine units who may benefit the most from medication reconciliation (ClinicalTrials.gov number NCT03422484).

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Section: Discussionmentioning

confidence: 99%

“…Our population also included a large proportion of admissions from emergency unit and during the night or weekend as described in many studies. 15,31,32…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a score to assess risk of medication errors detected during medication reconciliation process at admission in internal medicine unit: SCOREM study

et al. 2020

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“…As a result of their multiple comorbidities, patients admitted to general medicine units are often at risk of drug-related problems (DRPs) that may be associated with increased morbidity and mortality. [1][2][3] Despite general medicine units admitting a significant proportion of hospitalised patients at risk of many DRPs, the evidence to support the roles and impacts of pharmacists in this patient group is not well described. There is some evidence from overseas that supports pharmacists attending ward rounds and identifying DRPs in general medical populations; however, most of the evidence focuses on the impact of pharmacists identifying DRPs in a reactive model of care once a DRP has already occurred.…”

Section: Introductionmentioning

confidence: 99%

Systematic review of clinical outcomes of clinical pharmacist roles in hospitalised general medicine patients

Tong

Edwards

Hua

et al. 2020

Pharmacy Practice and Res

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Aim The role of clinical pharmacists in the care of hospitalised general medicine patients is evolving from a reactive model of care to a model with an emphasis on interdisciplinary care and more advanced models of care. The purpose of this review was to evaluate the published literature on the effects of roles of clinical pharmacists that extend beyond those activities considered to be standard clinical practice in Australia, on clinical outcomes in hospitalised general medicine patients. Data sources A search of English‐language publications in six databases was conducted. Study selection Peer‐reviewed, English‐language articles were identified across the date range January 2000 to June 2020. Studies were included if they evaluated an inpatient pharmacy service in a general medicine population and the article included a study design with a clear comparator and outcomes such as medication errors or medication appropriateness. Studies evaluating pharmacists’ activities that are considered standard clinical practice for pharmacists in Australia, such as participation on ward rounds, medication reconciliation and patient education were excluded. Results Twelve studies met the inclusion criteria: four evaluating pharmacist‐led anticoagulation or thromboprophylaxis management, one evaluating pharmacist‐led vaccination, three evaluating a pharmacist charting model, two evaluating pharmacist‐led de‐escalation of therapy, one evaluating a pharmacist intervention in patients with chronic kidney disease and one evaluating pharmacist‐led glycaemic control. Conclusions The addition of advanced clinical pharmacist services in the care of general medicine inpatients generally resulted in improved care, with no evidence of harm. Future studies should include multiple sites, larger sample sizes, reproducible interventions and identification of patient‐specific factors that lead to improved outcomes.

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“…Few MedRec studies have been published in the Middle East and North Africa (MENA) region. Three studies conducted in Saudi Arabia examined pharmacists’ role in collecting the best possible medication history (BPMH) within 24 hours of admission 11–13 . They showed that pharmacist can reduce medication errors and supported their involvement in the MedRec process.…”

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confidence: 99%

“…They showed that pharmacist can reduce medication errors and supported their involvement in the MedRec process. All published studies were conducted at the inpatient setting for recently hospitalized patients 11–13 . To date, no studies have been published in the region to evaluate the implementation of an ambulatory care MedRec service.…”

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confidence: 99%

Introduction of an Ambulatory Care Medication Reconciliation Service in Dialysis Patients: Positive Impact on Medication Prescribing and Economic Benefit

et al. 2021

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ObjectiveThe aim of the study was to assess the implementation of medication reconciliation (MedRec) and medication-related costs in dialysis-dependent patients.MethodsCompleted best possible medication history and reconciliation forms were collected within 6 months from 77 patients’ file at the dialysis center. Outcome measures were number and types of medication discrepancies, medication-related problems (MRPs), and their potential to cause harm, in addition to the type and number of interventions conducted during MedRec and the resulted medication costs reduction.ResultsThe mean number of medications was 11 ± 4, which was reduced to 8 ± 3 (P < 0.0001) after MedRec. Medication discrepancies accounted for 55, and MRPs were raised by pharmacists 216 times, and 55% had the potential to cause moderate patient discomfort. Mediations were held in 1.2%, discontinued in 21.2%, and changed in 5.4%, which led to €75.665 (U.S. $85.33) and €459.93 (U.S. $511.979) reduction in medication costs per patient for 1 and 6 months, respectively.ConclusionsSeveral discrepancies and MRPs were identified in the present study that put patients undergoing dialysis at risk for potential harm and adverse drug events. Regularly performing ambulatory MedRec and involving pharmacists in the model of care can improve the quality of healthcare delivered to dialysis-dependent patients and reduce cost.

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Prevention of medication errors at hospital admission: a single-centre experience in elderly admitted to internal medicine

Cited by 19 publications

References 24 publications

Development and validation of a score to assess risk of medication errors detected during medication reconciliation process at admission in internal medicine unit: SCOREM study

Development and validation of a score to assess risk of medication errors detected during medication reconciliation process at admission in internal medicine unit: SCOREM study

Systematic review of clinical outcomes of clinical pharmacist roles in hospitalised general medicine patients

Introduction of an Ambulatory Care Medication Reconciliation Service in Dialysis Patients: Positive Impact on Medication Prescribing and Economic Benefit

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