• 10
    Dec
  • Unintended Medication Discrepancies Associated with Reliance: RESULTS

To reach the intended sample size of 20 patients, a total of 33 patients were approached between September 2005 and January 2006 and asked to participate in the study. Of these, 2 who initially agreed to participate were discharged before their scheduled interview with the investigator; 2 additional patients were recruited to replace them, and the final sample size was 20 patients (Table 1), as planned. The study participants were mostly male and elderly, with 80% using 8 or more medications before admission. Eleven patients (55%) had prescription vials available for inspection during the interview.

For almost all participants (19 of 20), the medical staff consulted PharmaNet before writing the admission orders. For the remaining patient, medical staff consulted PharmaNet within 48 h after admission. The information in the PharmaNet profile was consistent with actual prescription medication use before admission (as indicated by the BPMH) for 8 patients (40%). The chart admission history was consistent with actual prescription medication use for 4 patients (20%). When nonprescription medications were included, the chart admission history was accurate for only 2 patients (10%). In all cases where the PharmaNet profile was inconsistent with actual medication use before admission, the chart admission history was also inconsistent. Nonprescription medication histories were not routinely recorded in the chart. Among 17 patients reporting the use of such medications before admission, only 11 (65%) had any history pertaining to nonprescription products in their chart notes. cialis 5 mg

Table 1. Characteristics of the Study Participants (n = 20)

Characteristic

No.(%) of Participants*


Sex


Male


12


(60)


Female


8


(40)


Age (years), mean ± SD



69


:


±

14.2


Admitted on Saturday or Sunday


9


(45)



Admitted after


8

PM


9


(45)


PharmaNet record reviewed by


medical staff on admission


19


(95)


No. of medications before


admission,t mean ± SD


11.1


±

3.4


Use of dosing or memory aid


12


(60)


Vials available for inspection


11


(55)


during interview


SD= standard deviation. *Unless indicated otherwise.

tIncludes both prescription and
nonprescription medications, according to best possible medication
history, based on interview with patient.

A total of 30 unintended admission order discrepancies were identified in the study population, 13 (43%) related to nonprescription medications and 17 (57%) related to prescrip­tion medications. These discrepancies occurred in 12 (60%) patients, the number of discrepancies per patient ranging from 0 to 7. Ten patients (50%) had at least 1 discrepancy involving a prescription medication, whereas 7 (35%) had at least 1 discrepancy involving a nonprescription medication. The median number of discrepancies was 1 (interquartile range 0 to 2) per patient. The most common type of discrepancy was the omission of regularly scheduled medications (n = 11 or 37% of all discrepancies), followed by discrepancies of commission, in which orders were written for medications that patients were no longer taking (n = 8 or 27%) (Table 2). canadian antibiotics

Table 2. Types of Discrepancies Identified

Type of Discrepancy

Nonprescription Drug

Prescription Drug

Sum (% of Total)



Omission



9



2



11 (37)



Commission*



4



4



8 (27)



Wrong drugt



0



5



5 (17)



Wrong dose



0



3



3 (10)



Wrong frequency



0



3



3 (10)



Total



13



17



30 (100)



*Defined as discrepancies involving orders for medications that the
patient was thought to be taking before admission, but that were not in
fact being taken. tDefined as discrepancies involving inadvertent
substitution of a new drug in hospital for one that was being taken
before admission.

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