Medication discrepancies across multiple care transitions: A retrospective longitudinal cohort study in Italy

Bonaudo, Marco; Martorana, Maria Cristina; Dimonte, Valerio; D’Alfonso, Alessandra; Fornero, G; Politano, Gianfranco; Gianino, Maria Michela

doi:10.1371/journal.pone.0191028

Cited by 21 publications

(21 citation statements)

References 34 publications

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“…In total, 14 studies reported data concerning the frequency of UMDs [49,50,57,59,60,66,70,74,83,84,88,93,95,98]. Three studies [83,84,93] used an established UMD definition, seven [49,50,59,60,70,74,95] developed their own and four [57,66,88,98] did not report any definition.…”

Section: Unintentional Medication Discrepancy Studiesmentioning

confidence: 99%

Prevalence and Nature of Medication Errors and Medication-Related Harm Following Discharge from Hospital to Community Settings: A Systematic Review

2020

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Background Little is known about the epidemiology of medication errors and medication-related harm following transition from secondary to primary care. This systematic review aims to identify and critically evaluate the available evidence on the prevalence and nature of medication errors and medication-related harm following hospital discharge. Methods Studies published between January 1990 and March 2019 were searched across ten electronic databases and the grey literature. No restrictions were applied with publication language or patient population studied. Studies were included if they contained data concerning the rate of medication errors, unintentional medication discrepancies, or adverse drug events. Two authors independently extracted study data. Results Fifty-four studies were included, most of which were rated as moderate (39/54) or high (7/54) quality. For adult patients, the median rate of medication errors and unintentional medication discrepancies following discharge was 53% [interquartile range 33-60.5] (n = 5 studies) and 50% [interquartile range 39-76] (n = 11), respectively. Five studies reported adverse drug reaction rates with a median of 27% [interquartile range 18-40.5] and seven studies reported adverse drug event rates with a median of 19% [interquartile range 16-24]. For paediatric patients, one study reported a medication error rate of 66.3% and another an adverse drug event rate of 9%. Almost a quarter of studies (13/54, 24%) utilised a follow-up period post-discharge of 1 month (range 2-180 days). Drug classes most commonly implicated with adverse drug events were antibiotics, antidiabetics, analgesics and cardiovascular drugs. Conclusions This is the first systematic review to explore the prevalence and nature of medication errors and adverse drug events following hospital discharge. Targets for future work have been identified.

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Section: Unintentional Medication Discrepancy Studiesmentioning

confidence: 99%

Prevalence and Nature of Medication Errors and Medication-Related Harm Following Discharge from Hospital to Community Settings: A Systematic Review

2020

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“…Most studies on the prevalence of drug discrepancies have been conducted in adult populations, usually focusing on a transition point in care [7,19,20]. However, a few similar studies in children have been reported [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

“…In this study, "lack of documentation" was defined as any situation in which there was no trace of clinical documentation. As the "lack of a documentation" did not allow to assess the presence or absence of discrepancies, we evaluated the possible hypothesis of "lack of documentation" was considered to be a discrepancy with the aim of considering the worst possible scenario [7].…”

Section: Evaluation Of Discrepanciesmentioning

confidence: 99%

“…Medication discrepancies usually occur in the absence of a standardized medication reconciliation system and when communication between healthcare sectors and levels is poor [7,8]. Medication reconciliation is defined as "the formal process in which health care professionals partner with patients to ensure accurate and complete medication information transfer at interfaces of care" and is considered one of the main strategies to ensure patient safety [9].…”

Section: Introductionmentioning

confidence: 99%

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Medication Discrepancies Involving Hospitalized Children At A High-Complexity Public Hospital

Lyra-Jr

Alcântara

Neto

et al. 2019

Preprint

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Background: Children are more susceptible to medication errors and adverse reactions. In addition, variation in body mass and medication discrepancies are the major causes of medication errors, which pose a risk of harm to children. When unresolved, these issues can lead to longer hospital stays, increased hospital readmissions, and emergency room care that burden the healthcare system. Many organizations have struggled to implement medication reconciliation. In this context, studies demonstrated that reliability and improvement science methods can be used to implement a successful and sustained medication reconciliation process. One of the initial steps involved in medication reconciliation process is determining the sector for implementation. Therefore, the aim of this study was to determine the prevalence of medication discrepancies occurring throughout the course of a hospital stay and describe the types of discrepancies and medications most commonly involved in pediatric cases. Methods: A cross-sectional study was carried out from July 2017 to March 2018 in the pediatric department of a high-complexity public hospital in Brazil. Data collection consisted of: collection of sociodemographic data, clinical interview with the patient's caregiver, registration of patient prescriptions, and evaluation of medical records. Discrepancies were classified as intentional or unintentional and included omission of medication, therapeutic duplicity, different dose, frequency, route of administration than prescribed. Study approved by the Research Ethics Committee (CAAE: 36927014.4.0000.5546). Results: During care transitions, 114 children were followed. Patients presented unintentional discrepancies, of which 16 (14.0%) presented discrepancies at hospital admission, 42 (36.8%) during ward transfer, and 52 (45.6%) during discharge. Omission represented 74% (n=20) ofthe errors at admission, 38% (n=26) at ward transfer, and 100% (n=80) at discharge. The most frequent discrepancies in the three transitions were related to antimicrobials, representing 43.3% of discrepancies at admission, 38.8% at internal transfer, and 61.2% during discharge. Conclusion: The results demonstrated that the main transition levels when unintentional discrepancies occurred in children in this hospital were during internal transfer and discharge and indicated difficulties in interprofessional communication and poor documentation. Evaluation of all transition points is essential for determining the most critical point in the quality of care provided at hospitals.

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“…Wszystko to stanowić może element kontynuacji procesu koncyliacji lekowej. Sensowność tego typu współpracy na linii personel medyczny szpitala -farmaceuta w aptece ogólnodostępnej została poparta licznymi badaniami [14][15][16].…”

Section: Dyskusjaunclassified

The role of a pharmacist in the medication reconciliation process

Fedorowicz¹,

Tusińska²,

Jaźwińska−Tarnawska³

2018

Farm Pol.

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Celem pracy było wykazanie roli farmaceuty w procesie koncyliacji lekowej i potrzeby prowadzenia tego procesu. Materiał i metody Charakterystyka grupy badanej Badaniem ankietowym objęto 156 osób. Wywiady z respondentami prowadzono w jednym z dolnośląskich szpitali, wśród pacjentów 2 oddziałów o profilu internistyczno-specjalistycznym, zwanych dalej Oddziałem I i Oddziałem II (tabela 1). Grupa respondentów została scharakteryzowana pod kątem takich parametrów jak: płeć, wiek, miejsce zamieszkania i wykształcenie. Collected data indicate the need for patient education on their pharmacotherapy because of their low comprehension of the subject. Medicament conciliation by a pharmacist could be a way to improve the therapy safety.

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Medication discrepancies across multiple care transitions: A retrospective longitudinal cohort study in Italy

Cited by 21 publications

References 34 publications

Prevalence and Nature of Medication Errors and Medication-Related Harm Following Discharge from Hospital to Community Settings: A Systematic Review

Prevalence and Nature of Medication Errors and Medication-Related Harm Following Discharge from Hospital to Community Settings: A Systematic Review

Medication Discrepancies Involving Hospitalized Children At A High-Complexity Public Hospital

The role of a pharmacist in the medication reconciliation process

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