Objectives:We sought to characterize the nature and prevalence of medication order errors (MOEs) occurring at hospital admission for children with medical complexity (CMC), as well as identify the demographic and clinical risk factors for CMC experiencing MOEs.Methods: Prospective cohort study of 1233 hospitalizations for CMC from November 1, 2015, to October 31, 2016, at 2 children's hospitals. Medication order errors at admission were identified prospectively by nurse practitioners and a pharmacist through direct patient care. The primary outcome was presence of at least one MOE at hospital admission. Statistical methods used included χ 2 test, Fisher exact tests, and generalized linear mixed models.Results: Overall, 6.1% (n = 75) of hospitalizations had ≥1 MOE occurring at admission, representing 112 total identified MOEs. The most common MOEs were incorrect dose (41.1%) and omitted medication (34.8%). Baclofen and clobazam were the medications most commonly associated with MOEs. In bivariable analyses, MOEs at admission varied significantly by age, assistance with medical technology, and numbers of complex chronic conditions and medications (P < 0.05). In multivariable analysis, patients receiving baclofen had the highest adjusted odds of MOEs at admission (odds ratio, 2.2 [95% confidence interval, 1.2-3.8]).Conclusions: Results from this study suggest that MOEs are common for CMC at hospital admission. Children receiving baclofen are at significant risk of experiencing MOEs, even when orders for baclofen are correct. Several limitations of this study suggest possible undercounting of MOEs during the study period. Further investigation of medication reconciliation processes for CMC receiving multiple chronic, home medications is needed to develop effective strategies for reducing MOEs in this vulnerable population.

Our understanding of the prevalence of mental health disorders (MHDs) in society is in the midst of a paradigm shift: where MHDs were once considered rare within a population, studies through the last decade have converged to the conclusion that they are, in fact, near universal. Consequently, the demand for mental health treatment has resulted in the training of Primary-Care Physicians (PCPs) to identify, diagnose, and treat common MHDs. As generalists, PCPs require specialised point-of-care clinical resources to educate their patients and provide them with evidence-based treatment plans; UpToDate is one such resource. As a database of synthesized peer-reviewed medical information, written and approved by physician-experts from their review of contemporary peer-reviewed literature, this resource is considered a gold standard. Here, we examine an MHD-specific investigative case study on Generalized Anxiety Disorder where the synthesized UpToDate medical information was found to be in conflict with the original studies. In this era of unrelenting bombardment of digital data, the responsibility of assessing the truth of the information falls to the consumer. While a reliance on reputable information-sharing platforms facilitates both the access and assessment of truth, we discuss the risks of unintended errors, their propagation, and the potential impact at the point-of-care.