Abstract
BACKGROUND
Preoperative screening (POS) may help to reduce medication errors at admission (MEA). However, due to the time window between POS and hospital admission, unintentional medication discrepancies may still occur and thus a second medication reconciliation at hospital admission is necessary. Insight into potential risk factors associated with these discrepancies would be helpful to focus the second medication reconciliation on high risk patients.
OBJECTIVE
To determine the occurrence of MEA and to identify risk factors for MEA in preoperatively screened patients.
METHODS
This single-centre observational cross-sectional study included elective surgical patients between 26 October and 18 December 2015. Main inclusion criteria were age ≥18 years and elective non-day care admissions. Medication reconciliation took place at the preoperative screening and was repeated within 30 hours of admission. Unintended discrepancies between the first and second medication reconciliation were defined as MEA. The primary outcome was the occurrence of MEA in preoperatively screened patients. The association of this outcome with potential risk factors was analysed using multivariate logistic regression analysis.
RESULTS
Of the 183 included patients 60 (33%) patients had at least one MEA. In a multivariate model the number of medications at POS (adjusted odds ratio 1.16, 95%-confidence interval [95%-CI] 1.04-1.30), and respiratory disease (odds ratio 4.25, 95%-CI 1.52-11.83) were significantly associated with MEA.
CONCLUSION
In our study MEA occurred in 33% of preoperatively screened patients. Polypharmacy and respiratory comorbidities are risk factors for MEA in preoperatively screened patients.
Preoperative screening (POS) may help to reduce medication errors at admission (MEA). However, due to the time window between POS and hospital admission, unintentional medication discrepancies may still occur and thus a second medication reconciliation at hospital admission is necessary. Insight into potential risk factors associated with these discrepancies would be helpful to focus the second medication reconciliation on high risk patients.
OBJECTIVE
To determine the occurrence of MEA and to identify risk factors for MEA in preoperatively screened patients.
METHODS
This single-centre observational cross-sectional study included elective surgical patients between 26 October and 18 December 2015. Main inclusion criteria were age ≥18 years and elective non-day care admissions. Medication reconciliation took place at the preoperative screening and was repeated within 30 hours of admission. Unintended discrepancies between the first and second medication reconciliation were defined as MEA. The primary outcome was the occurrence of MEA in preoperatively screened patients. The association of this outcome with potential risk factors was analysed using multivariate logistic regression analysis.
RESULTS
Of the 183 included patients 60 (33%) patients had at least one MEA. In a multivariate model the number of medications at POS (adjusted odds ratio 1.16, 95%-confidence interval [95%-CI] 1.04-1.30), and respiratory disease (odds ratio 4.25, 95%-CI 1.52-11.83) were significantly associated with MEA.
CONCLUSION
In our study MEA occurred in 33% of preoperatively screened patients. Polypharmacy and respiratory comorbidities are risk factors for MEA in preoperatively screened patients.
| Translated title of the contribution | Risk factors for medication erros at admission in preoperatively screened patients |
|---|---|
| Original language | Dutch |
| Article number | a1661 |
| Journal | Nederlands Platform voor Farmaceutisch Onderzoek |
| Issue number | 3 |
| Publication status | Published - Jan-2018 |
| Externally published | Yes |