Drug-related problems in medical wards with a computerized physician order entry system

Bedouch, Pierrick; Allenet, Benoît; Grass, Alejandro Caparrós; Labarère, José; Brudieu, É.; Bosson, Jean‐Luc; Calop, J.

doi:10.1111/j.1365-2710.2008.00990.x

Cited by 55 publications

(48 citation statements)

References 31 publications

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“…In similar studies conducted on hospitalized patients; Viktil et al [15] identified an average of 2.1 DRPs per patient, Bedouch et al [32] identified an average of 1.7 DRPs and Koh et al [33] identified an average of 1.3 DRPs. The high number of TRPs identified in the current study should be interpreted taking into account the following points: first; we were not able to include all patients, but only high risk patients who were using more medications and suffering from more diseases.…”

Section: Discussionmentioning

confidence: 93%

“…During the last 20 years clinical pharmacist became a unique and efficient member of the healthcare team and contributed substantially to the wellbeing of patients in the different health care settings [10][11][12][13][14][15][16][17][18][19][20][30][31][32][33]. Despite this, clinical pharmacy is very slowly progressing in the developing countries.…”

Section: Discussionmentioning

confidence: 97%

“…In the above mentioned studies [15,32,33] the average number of medications received by patients were around 5.…”

Section: Discussionmentioning

confidence: 98%

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Comprehensive assessment of treatment related problems in hospitalized medicine patients in Jordan

et al. 2011

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We have found that prevalence of TRPs is substantially high among patients hospitalized at the internal medicine department. TRPs related to Dosage regimens, untreated conditions, patient monitoring, drug interactions, and drug choices were the most common. Most of TRPs identified by pharmacists were clinically significant. Pharmacists' interventions contributed substantially to the resolving of many of the identified TRPs. Patients suffering from higher number of medical conditions and receiving higher number of medications should be given the priority for clinical pharmacy service in hospitalized internal medicine patients.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 97%

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Comprehensive assessment of treatment related problems in hospitalized medicine patients in Jordan

et al. 2011

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“…Electronic prescribing has proven to reduce drug prescription errors [27], and CPOE with clinical decision support (CDS) can improve patient safety [8,28]. Still, occurrence of DRPs persists and pharmacists can enhance patient safety, despite CPOE [7,8]. Electronic prescribing presents possibilities for standardisation of prescriptions using CDS such as prescription templates.…”

Section: Introductionmentioning

confidence: 99%

“…The majority of hospitalised patients have drug-related problems (DRPs) [1][2][3][4][5][6][7][8][9][10][11] which are events or circumstances involving drug therapy that actually or potentially can interfere with the desired health outcomes [12]. The total cost of drug-related morbidity and mortality exceeds the cost of the medications themselves [3].…”

Section: Introductionmentioning

confidence: 99%

Clinical pharmacist service in the acute ward

Nielsen

Andersen

Rasmussen³

et al. 2013

Int J Clin Pharm

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Background The majority of hospitalised patients have drug-related problems. Clinical pharmacist services including medication history, medication reconciliation and medication review may reduce the number of drug-related problems. Acute and emergency hospital services have changed considerably during the past decade in Denmark, and the new fast-paced workflows pose new challenges for the provision of clinical pharmacist service. Objective To describe and evaluate a method for a clinical pharmacist service that is relevant and fit the workflow of the medical care in the acute ward. Setting Acute wards at three Danish hospitals. Methods The clinical pharmacist intervention comprised medication history, medication reconciliation, medication review, medical record entries and entry of prescription templates into the electronic medication module. Drug-related problems were categorised using The PCNE Classification V6.2. Inter-rater agreement analysis was used to validate the tool. Acceptance rates were measured as the physicians' approval of prescription templates and according to outcome in the PCNE classification. Main outcome measure Acceptance rate of the clinical pharmacists' interventions through the described method and inter-rater agreement using the PCNE classification for drug-related problems. Results During 17 months, 188 patients were included in this study (average age 72 years and 55 % women). The clinical pharmacists found drug-related problems in 85 % of the patients. In the 1,724 prescriptions, 538 drug-related problems were identified. The overall acceptance rate by the physicians for the proposed interventions was 76 % (95 % CI 74-78 %). There was a substantial inter-rater agreement when using the PCNE classification system. Conclusion The methods for a clinical pharmacist service in the acute ward in this study have been demonstrated to be relevant and timely. The method received a high acceptance rate, regardless of no need for oral communication, and a substantial inter-rater agreement when classifying the drug-related problems.

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Identifying medication error chains from critical incident reports: A new analytic approach

Huckels-Baumgart

Manser

2014

The Journal of Clinical Pharmacology

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Research into the distribution of medication errors usually focuses on isolated stages within the medication use process. Our study aimed to provide a novel process-oriented approach to medication incident analysis focusing on medication error chains. Our study was conducted across a 900-bed teaching hospital in Switzerland. All reported 1,591 medication errors 2009-2012 were categorized using the Medication Error Index NCC MERP and the WHO Classification for Patient Safety Methodology. In order to identify medication error chains, each reported medication incident was allocated to the relevant stage of the hospital medication use process. Only 25.8% of the reported medication errors were detected before they propagated through the medication use process. The majority of medication errors (74.2%) formed an error chain encompassing two or more stages. The most frequent error chain comprised preparation up to and including medication administration (45.2%). "Non-consideration of documentation/prescribing" during the drug preparation was the most frequent contributor for "wrong dose" during the administration of medication. Medication error chains provide important insights for detecting and stopping medication errors before they reach the patient. Existing and new safety barriers need to be extended to interrupt error chains and to improve patient safety.

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Drug-related problems in medical wards with a computerized physician order entry system

Abstract: Drug-related problems are common even after implementation of CPOE. In this context, routine participation of clinical pharmacists in clinical medical rounds may facilitate identification of DRPs. Pharmacists should be able to enhance patient safety through such involvement.

Cited by 55 publications

References 31 publications

Comprehensive assessment of treatment related problems in hospitalized medicine patients in Jordan

Comprehensive assessment of treatment related problems in hospitalized medicine patients in Jordan

Clinical pharmacist service in the acute ward

Identifying medication error chains from critical incident reports: A new analytic approach

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