Highlights
- •Medication reconciliation is a powerful process to correct medication errors (ME).
- •The potential clinical impact of these intercepted ME has to be assessed.
- •The multi-centre study has validated a method to score the potential severity of ME.
- •A database of ME of serious potential clinical significance will be constituted.
Abstract
Background
Medication reconciliation is a powerful process to correct medication errors (ME)
resulting from miscommunicated information at transitions of care. This study aims
to develop and evaluate a scoring method for assessing the severity of potential harm
of ME intercepted by medication reconciliation at hospital admission in elderly.
Methods
The development of the scoring method was based on a literature search and the creation
of a list of high-risk drugs used in outpatient care. The evaluation of the method
was carried out in 7 French hospitals and was based on two criteria: the inter-rater
reliability and acceptability. The assessment of the inter-rater reliability was based
on intra-class correlation coefficient (ICC) calculations. Each hospital prospectively
enrolled the 10 first patients aged 65 or older presenting with at least one ME. Seven
blocks of 10 patients were formed. After randomization, each block was rated by practitioners
from 3 hospitals. The assessment of the acceptability was based on a satisfaction
questionnaire.
Results
A clinical algorithm was developed. The inter-rater reliability of the method was
validated by the overall agreement of the 7 hospitals ratings. The agreement was at
least substantial (ICC > 0.60) and in most of cases almost perfect (ICC > 0.80). The acceptability of the method was judged as satisfactory.
Conclusion
This multi-centre project has validated an instrument for assessing the severity of
potential harm of ME intercepted by medication reconciliation. This will allow studies
to be conducted with large cohorts of patients in order to develop epidemiological
databases of ME of potential clinical significance.
Keywords
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Article info
Publication history
Published online: July 21, 2015
Accepted:
July 9,
2015
Received in revised form:
July 7,
2015
Received:
April 17,
2015
Identification
Copyright
© 2015 European Federation of Internal Medicine. Published by Elsevier Inc. All rights reserved.
