Medication errors detected in elderly patients admitted to an internal medicine service

Abstract

Background: Depression (ICD-10 F33) is highly prevailing in general population, especially among elderly patients. It is associated with an increase of morbidity and mortality. In 1996, an study of elderly depression in the Military Hospital of Santiago showed a prevalence of 28,4% in admitted patients. Objectives: To describe the prevalence of late life depression in patients admitted to an Internal Medicine Service. Methods: Patients were interviewed between 06-02-2009 and 09-06-2009. Inclusion criteria: Elder than 60 years old and admitted in the last 24 hours. Exclusion criteria: Pfeiffer > 3, Glasgow < 15, aphasias, VAS > 5, mental and terminal illness. Results: 131 patients were interviewed, 64 women and 67 men, mean age of 74,35 (DE 8,23) years old. Depression Prevalence was 22,13% (29), 28,12% (18) in women and 16,41% (11) in men. Discussions: Late life depression in patients admitted to an Internal Medicine Service is common and often undetected or undertreated.

Medication safety in neonatal care: a review of medication errors among neonates

“…Incorrect dosing was most commonly reported, comprising 49% of prescribing errors [Briggs, 2006;Picone et al 2008;Ben-Yehuda et al 2011;Maher and Hajjar, 2012;Buck et al 2013;García-Aparicio and Herrero-Herrero, 2013;Ernawati et al 2014;Metsälä and Vaherkoski, 2014]. A unique error commonly reported in the elderly population involved the prescribing of inappropriate medications [Briggs, 2006;Picone et al 2008;Ben-Yehuda et al 2011;Maher and Hajjar, 2012;Buck et al 2013;García-Aparicio and Herrero-Herrero, 2013;Ernawati et al 2014;Metsälä and Vaherkoski, 2014]. Described as the ordering of medications that are unnecessary, ineffective or unsafe, these errors most often occur in elderly patients who present with multiple pathologies, requiring multiple medications [Maher and Hajjar, 2012].…”

“…In addition, the formulation of populationspecific quality control tools and health indicators has also been regarded as important in improving medication error rates [Bohomol et al 2009]. However, the most commonly cited strategy identified in half of the literature across all patient groups, is the involvement of a clinical pharmacist on wards [Folli et al 1987;Bates et al 1995;Wilson et al 1998;Kaushal et al 2001;Kozer et al 2002;Van Den Bemt et al 2002;Fortescue et al 2003;Gray and Goldmann, 2004;Simpson et al 2004;Kunac and Reith, 2005;Lisby et al 2005;Briggs, 2006;Bohomol et al 2009;Campino et al 2009;Condren et al 2010;Wong et al 2009;Ghaleb et al 2010;Ben-Yehuda et al 2011;Jennane et al 2011;Antonucci and Porcella, 2012;Dabliz and Levine, 2012;Henri et al 2012;Maher and Hajjar, 2012;Sorrentino and Alegiani, 2012;García-Aparicio and Herrero-Herrero, 2013;Ernawati et al 2014;Metsälä and Vaherkoski, 2014]. Fortescue and colleagues report that 81% of medication errors in paediatric patients could be avoided with pharmacist monitoring [Fortescue et al 2003].…”

“…Among the 10 articles reviewed, medication errors were most commonly identified through prospective observational studies, and retrospective review of charts and incident reports [Briggs, 2006;Picone et al 2008;Ben-Yehuda et al 2011;Henri et al 2012;Maher and Hajjar, 2012;Zakharov et al 2012;Buck et al 2013;García-Aparicio and Herrero-Herrero, 2013;Ernawati et al 2014;Metsälä and Vaherkoski, 2014]. The median age of elderly participants ranged from 68 to 84 years of age [Picone et al 2008;Ben-Yehuda et al 2011;Buck et al 2013;García-Aparicio and HerreroHerrero, 2013;Ernawati et al 2014].…”

“…Chemotherapy drugs [Folli et al 1987;Ross et al 2000] Antineoplastic agents [Winterstein et al 2004] Antineoplastic agents: Azathioprine, Doxorubicin [Picone et al 2008] Anti-arrhythmics [Frey et al 2002] Captopril [Wong et al 2009]; Digoxin [Folli et al 1987;Wong et al 2009]; Propranolol [Folli et al 1987] Calcium-channel blockers [Winterstein et al 2004]; Digoxin [Calabrese et al 2001]; Sympathomimetic agents: Dobutamine [Calabrese et al 2001;Winterstein et al 2004] Cardiovascular: Digoxin, Metoprolol, Amiodarone [Picone et al 2008;García-Aparicio and Herrero-Herrero, 2013;Ernawati et al 2014]; Isosorbide mononitrate [García-Aparicio and Herrero-Herrero, 2013] Frusemide [Frey et al 2002;Stavroudis et al 2010] Frusemide [Picone et al 2008;García-Aparicio and Herrero-Herrero, 2013] Ranitidine [Pallas et al 2008] Docusate sodium [Winterstein et al 2004]; H 2 antagonists [Winterstein et al 2004]; Metoclopramide [Winterstein et al 2004]; GI Drugs: Docusate, Omeprazole [Picone et al 2008;García-Aparicio and Herrero-Herrero, 2013;Ernawati et al …”

Medication Review and Transitions of Care: A Case Report of a Decade-Old Medication Error

“…9 The elderly are more likely to incur medication errors, and though most studies do not include patients with poor cognition, there are those that do show that cognition and the inability to direct one's own care are independent factors associated with transitions-of-care errors. 2,4,5,10, 11 Adverse drug events (ADEs) are more likely to occur in patients when medication changes are made transitioning from inpatient to long-term care or vice versa. 12 Additionally, ADEs associated with inpatient changes most often appear after return to long-term care, and patients with more chronic comorbid conditions are more likely to experience these ADEs.…”