Unintended Medication Discrepancies Associated with Reliance
Medication errors are thought to account for up to 20% of all adverse reactions experienced in the hospital setting. One common source of medication error occurs on admission, when the health care provider collects information about the patient’s medications before admission and then decides to continue or discontinue these medications during the hospital stay. Adverse events can arise if there is an unintended discrepancy between the patient’s actual medication history and the medications ordered in the hospital. In 2005, Cornish and others2 reported that for 53.6% of study patients at a 1000- bed tertiary care hospital in Ontario, there were unintended discrepancies between orders written on admission to a general medicine ward and an interview-based medication history. Thirty-nine percent of these discrepancies were identified as having the potential to cause moderate or severe patient discomfort or clinical deterioration.
One potentially attractive option to minimize these errors is the use of pharmacy databases that record medication prescriptions filled at outpatient pharmacies. In British Columbia, pharmacies and hospitals have access to PharmaNet, an electronic, patient-specific record of prescriptions filled at all outpatient pharmacies throughout the province within the previous 14 months.
Although medication information from this type of drug database is increasingly being used as an aid in obtaining patients’ medication history, little is known about the accuracy of this process. This pilot study was undertaken with the primary objective of quantifying and describing unintended medication discrepancies between medications ordered by physicians at the time of admission and a best possible medication history (a best-practice, interview-based medication history) for patients admitted to a general medicine ward in a tertiary care hospital with routine access to PharmaNet data. In addition, possible explanatory factors associated with these discrepancies were explored. vardenafil 20 mg
A disparites entre le registre PharmaNet et les medicaments reels du patient, jumelees a l’absence de verification des donnees tirees de PharmaNet avec les patients, constituaient vraisemblablement des facteurs contribuant a de telles differences accidentelles.
Mots cles : histoire medicamenteuse, bilan comparatif des medicaments, base de donnees sur les medicaments d’ordonnance, erreurs de medication