The rate and nature of medication errors among elderly upon admission to hospital after implementation of clinical pharmacist-led medication reconciliation

Abstract

Objectives To determine the frequency and nature of erroneous transfer of medication information (medication errors) upon admission to hospital and to study the effect of medication reconciliation. Methods Included patients were 65 years of age or older, were living in nursing homes or in their own home with care provided by the community nursing system and had been admitted to hospital. The patients’ medication lists from the community were compared with the hospital medication lists upon admission in order to study the discrepancies between the lists. The proportion of errors that were corrected by day 4 of hospitalisation was also studied as a measure of the effect of medication reconciliation conducted by clinical pharmacists who aimed to identify the patients’ accurate and complete medication history. Results A total of 149 patients were included over a 10-month period. In 68 (46%) patients, there occurred at least one medication error, with an average of 0.95 errors per patient. Overall, 8.0% of all drug transfers were found to be incorrect. The clinical pharmacists detected all medication errors upon admission and 43% of them were corrected before day 4 of hospitalisation. Conclusions Medication errors upon admission to hospital are common; use of clinical pharmacists in the admission medication reconciliation process appears to be a useful method to reduce medication errors, but since our study lacked a control group further studies are needed to show the actual impact of pharmacist-led medication reconciliation upon admission to hospital. Furthermore, more actions are needed to enhance the safety and quality of medication information transfers.

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“…The value of the pharmacist in medicines reconciliation was also shown in a Swedish medical ward though the researchers suggested more work is needed. 20 …”

Drug use among men with unfulfilled wish to father children: a retrospective analysis and discussion of specific drug classes

“…Additionally, we presume that patients often did not report all drugs and recreational products, even on request. Studies on medication reconciliation showed that the way questions are phrased strongly influences the number of reported drugs . In addition, we found documented diseases requiring treatment without mention of a corresponding drug.…”

“…Studies on medication reconciliation showed that the way questions are phrased strongly influences the number of reported drugs. [55][56][57][58] In addition, we found documented diseases requiring treatment without mention of a corresponding drug. Another limiting factor was the poor quality of information on potential ADRs on male fertility.…”

A comparative study of voluntarily reported medication errors among adult patients in intensive care (IC) and non- IC settings in Riyadh, Saudi Arabia

“…The use of computerized physician order entry reduced medication prescription errors to 3.4 % of orders in comparison to paper-based orders where the error rate was about 27 % in one study [17]. The study site is also covered by pharmaceutical care services, where clinical pharmacists review and follow up all patients medication from admission till discharge, which may have significantly impacted the incidence of medication errors [18]. The availability of pharmacist support for more than 15 hours per day has been associated with a higher interception of near misses and prescribing errors in one study [19].…”