Evaluation of a Novel Audit Tool  for Medication Reconciliation  at Hospital Discharge

Holbrook, Anne; Bannerman, H; Ahmed, Amna; Georgy, Michael; Liu, J Tiger; Troyan, Sue; Watt, Alice

doi:10.4212/cjhp.v72i6.2941

Cited by 1 publication

(2 citation statements)

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“…Another process that is important to be inserted in the clinical pharmacy routine at each transition of care, including hospital discharge, is medication reconciliation 34 . Studies show that prescription errors that occur on hospital admission can occur in up to 67% of cases and that errors that can lead to adverse drug events after discharge can be even higher, exceeding the rate of 70% 35 . Medication reconciliation is considered a beneficial practice, being able to reduce drug‐related problems 36 …”

Section: Discussionmentioning

confidence: 99%

“…34 Studies show that prescription errors that occur on hospital admission can occur in up to 67% of cases and that errors that can lead to adverse drug events after discharge can be even higher, exceeding the rate of 70%. 35 Medication reconciliation is considered a beneficial practice, being able to reduce drug-related problems. 36 The development of a predictive algorithm to identify patients at risk of suffering serious harm related to drug use ranks fourth on the list of research priorities for drug safety.…”

Section: Discussionmentioning

confidence: 99%

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Fully independent validation and updating of a clinical pharmacy prioritizing risk score in an infectious disease hospital ward

Barreto

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Santos

et al. 2022

Brit J Clinical Pharma

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The aim of this study was to validate and update the risk score originally developed at Hospital de Clínicas de Porto Alegre, verifying its performance in an infectious disease population.Methods: This is an observational study with consecutive selection of admission in a ward of participants with infectious diseases. Predictors were age, number of medications, intravenous drugs, potentially dangerous drugs, renal dysfunction, liver dysfunction, use of nasoenteral tube, nasogastric tube, gastrostomy feeding, jejunostomy feeding, oral enteral tube, total parenteral nutrition, cardiac or pulmonary dysfunction and immunosuppression. Outcome was defined as preventable prescription incidents by a clinical pharmacist. A GEE model was fit to make predictions each week. Results: A total of 219 patients participated in the study, 79.25% of whom had prescription incidents in the first week of admission. Predictors of the updated model were number of drugs prescribed, number of intravenous drugs, use of tubes, truncated age at 36 years and week of hospitalization. The performance of the original model was poor. The updated model's discrimination and calibration were moderate (overall AUC 0.74). A calculator to apply the model is available at https://pedrobrasil. shinyapps.io/INDWELL/. Conclusion: The updated risk score enabled the user to make predictions at admission and throughout the weeks, allowing for a prioritized weekly update for clinical pharmacy intervention. The updated model has a moderate and satisfactory performance for infectious disease patients. K E Y W O R D S clinical pharmacy service, drug-related side effects and adverse reactions, forecasting, medication errors, risk assessment, risk score 1 | INTRODUCTION Medication errors can be defined as any preventable event that can cause or lead to medication misuse or harm to the patient while theThe authors confirm that the Principal Investigator for this paper is Pedro Emmanuel Alvarenga Americano do Brasil and that he has direct clinical responsibility for patients.

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Section: Discussionmentioning

confidence: 99%