Highlights
- •Clinical pharmacists detected and corrected medication errors in about a fourth of our cohort.
- •Diabetic patients had more (and more serious) medication errors both at admission and at discharge.
- •Number of treatments, and not diabetic status itself, was associated with more medication errors.
Abstract
Background
Medication errors (ME) are major public health issues in hospitals because of their
consequences on patients' morbi-mortality. This study aims to evaluate the prevalence
of ME at admission and discharge of hospitalization in diabetic and non-diabetic patients,
and determine their potential clinical impact.
Method
This prospective observational study was conducted at the Endocrinology-Diabetology-Nutrition
Department. All adult patients admitted were eligible. A total of 904 patients were
included, of which 671 (74.2%) with diabetes mellitus. Clinical pharmacists conducted
medication reconciliation: they collected the Best Possible Medication History and
then compared it with admission and discharge prescriptions to identify medication
discrepancies. ME were defined as unintended medication discrepancies if corrected
by the physician.
Results
Clinical pharmacists allowed correcting ME in 176/904 (19.5%) patients at admission
and in 86/865 (9.9%) patients at discharge. More than half of ME were omissions. Diabetic
patients were more affected by ME than non-diabetic patients, both at admission (22.1%
vs 12.0%, p < 0.001) and at discharge (11.4% vs 5.7%, p = 0.01). The diabetic group also had more potentially severe and very severe ME. Diabetic
patients had on average twice more medications than non-diabetic patients (8.7 ± 4.5 vs 4.4 ± 3.4, p < 0.001). The polypharmacy associated with diabetes, but not diabetes mellitus itself,
was identified as a risk factor of ME.
Conclusions
The intervention of clinical pharmacists allowed correcting 378 ME in 25.8% of the
cohort before they caused harm. Clinicians, pharmacists and other health care providers
should therefore work together to improve patients' safety, in particular in high-risk
patients such as diabetic patients.
Keywords
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Article info
Publication history
Published online: December 19, 2016
Accepted:
December 7,
2016
Received in revised form:
November 23,
2016
Received:
September 27,
2016
Identification
Copyright
© 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
