What is the patient really taking? Discrepancies between surgery and anesthesiology preoperative medication histories

Abstract

Background: Surgical patients may be at risk for medication discrepancies that may lead to medication errors because both the anesthesiologist and the surgeon write separate preoperative medication histories. Methods: A prospective observational study was conducted to examine the extent of medication and allergy discrepancies between surgical and anesthesia preoperative medication histories for patients admitted to two surgical intensive care units in an academic medical center. Results: Of the 79 patient records reviewed, 58 (73%) contained at least one discrepancy, 23% had different allergy information, 56% had different preoperative medications, and 43% had different doses or dosing frequencies listed in the medication histories. Of the 988 allergies, medications, and doses or dosing frequencies documented in the two histories, 456 (46%) contained discrepancies. Of these discrepancies, 20 (5%) were due to different allergies, 293 (64%) to different medications, and 143 (31%) to different doses or dosing frequencies. Conclusions: Discrepancies in preoperative medication histories between surgical and anesthesia records occur in most patients and further work is required to help improve agreement of patient medication histories between services.

Discrepancies between sources providing the medication histories of acutely hospitalised patients

“…This is also the finding of the present study, as the many discrepancies found can be assumed to lead to problems in taking medication histories [18,19]. Similarly, it was found that PEM can improve medication histories.…”

Factors Contributing to Perioperative Medication Errors: A Systematic Literature Review

“…Organizations should consider the inclusion of pharmacists in the perioperative areas during care transitions to oversee patients’ medications as they move into and out of the surgical area. Surgeons, nurses, and anesthesia care providers may receive different medication lists or may place conflicting orders . Bell et al found that, postoperatively, patients’ medications were discontinued unintentionally 7.5% of the time; warfarin was the medication most commonly discontinued.…”

Insufficient communication about medication use at the interface between hospital and primary care

“…2 An important cause of medication-prescribing errors leading to adverse drug events is polypharmacy combined with lack of knowledge of patients' medication use at time of prescribing. [3][4][5] Upon hospitalisation the patient is often the primary source of information about a prescribed medication regimen. However, due to patients' recall bias supplementary information is often needed from district nurses, general practitioners or pharmacies.…”