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Risk factors for unintentional medication discrepancies at hospital admission: A matched case-control study

Published:February 10, 2017DOI:https://doi.org/10.1016/j.ejim.2017.02.003
Risk factors for unintentional medication discrepancies at hospital admission: A matched case-control study
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      Unintentional medication discrepancies (UMD) are defined as erroneous and unjustified medication changes between the medication use history and the admission medication orders. UMD (e.g., medication omissions, incorrect doses, incorrect frequencies of administration, therapeutic duplications, among others) are distinguished from intentional medication discrepancies in which adjustments guided by the patient's clinical condition are made at the time of admission [
      • Cornish P.L.
      • Knowles S.R.
      • Marchesano R.
      • et al.
      Unintended medication discrepancies at the time of hospital admission.
      Arch Intern Med. 2005; 165: 424-429
      ]. Previous studies observed that 14.7% to 66.2% of identified UMD at admission or discharge are able to cause potential damage to patients [
      • Cornish P.L.
      • Knowles S.R.
      • Marchesano R.
      • et al.
      Unintended medication discrepancies at the time of hospital admission.
      Arch Intern Med. 2005; 165: 424-429
      ,
      • Michel B.
      • Quelennec B.
      • Andres E.
      Medication reconciliation practices and potential clinical impact of unintentional discrepancies.
      JAMA Intern Med. 2013; 173: 246-247
      ,
      • Wong J.D.
      • Bajcar J.M.
      • Wong G.G.
      • et al.
      Medication reconciliation at hospital discharge: evaluating discrepancies.
      Ann Pharmacother. 2008; 42: 1373-1379
      ]. Discrepancies between the medications patients taken before admission and those listed in their admission orders range from 50% to 70% [
      • Cornish P.L.
      • Knowles S.R.
      • Marchesano R.
      • et al.
      Unintended medication discrepancies at the time of hospital admission.
      Arch Intern Med. 2005; 165: 424-429
      ,
      • Tam V.C.
      • Knowles S.R.
      • Cornish P.L.
      • et al.
      Frequency, type and clinical importance of medication history errors at admission to hospital: a systematic review.
      CMAJ. 2005; 173: 510-515
      ,
      • Pippins J.R.
      • Gandhi T.K.
      • Hamann C.
      • et al.
      Classifying and predicting errors of inpatient medication reconciliation.
      J Gen Intern Med. 2008; 23: 1414-1422
      ,
      • Mixon A.S.
      • Myers A.P.
      • Leak C.L.
      • et al.
      Characteristics associated with postdischarge medication errors.
      Mayo Clin Proc. 2014; 89: 1042-1051
      ]. Several studies have investigated the prevalence of UMD, but few have focused on its causes [
      • Tam V.C.
      • Knowles S.R.
      • Cornish P.L.
      • et al.
      Frequency, type and clinical importance of medication history errors at admission to hospital: a systematic review.
      CMAJ. 2005; 173: 510-515
      ,
      • Mixon A.S.
      • Myers A.P.
      • Leak C.L.
      • et al.
      Characteristics associated with postdischarge medication errors.
      Mayo Clin Proc. 2014; 89: 1042-1051
      ,
      • Unroe K.T.
      • Pfeiffenberger T.
      • Riegelhaupt S.
      • et al.
      Inpatient medication reconciliation at admission and discharge: a retrospective cohort study of age and other risk factors for medication discrepancies.
      Am J Geriatr Pharmacother. 2010; 8: 115-126
      ]. Until this date, there are no case-control or cohort studies of risk factors for UMD.

      Keywords

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      References

        • Cornish P.L.
        • Knowles S.R.
        • Marchesano R.
        • et al.
        Unintended medication discrepancies at the time of hospital admission.
        Arch Intern Med. 2005; 165: 424-429
        View in Article
        • Michel B.
        • Quelennec B.
        • Andres E.
        Medication reconciliation practices and potential clinical impact of unintentional discrepancies.
        JAMA Intern Med. 2013; 173: 246-247
        View in Article
        • Wong J.D.
        • Bajcar J.M.
        • Wong G.G.
        • et al.
        Medication reconciliation at hospital discharge: evaluating discrepancies.
        Ann Pharmacother. 2008; 42: 1373-1379
        View in Article
        • Tam V.C.
        • Knowles S.R.
        • Cornish P.L.
        • et al.
        Frequency, type and clinical importance of medication history errors at admission to hospital: a systematic review.
        CMAJ. 2005; 173: 510-515
        View in Article
        • Pippins J.R.
        • Gandhi T.K.
        • Hamann C.
        • et al.
        Classifying and predicting errors of inpatient medication reconciliation.
        J Gen Intern Med. 2008; 23: 1414-1422
        View in Article
        • Mixon A.S.
        • Myers A.P.
        • Leak C.L.
        • et al.
        Characteristics associated with postdischarge medication errors.
        Mayo Clin Proc. 2014; 89: 1042-1051
        View in Article
        • Unroe K.T.
        • Pfeiffenberger T.
        • Riegelhaupt S.
        • et al.
        Inpatient medication reconciliation at admission and discharge: a retrospective cohort study of age and other risk factors for medication discrepancies.
        Am J Geriatr Pharmacother. 2010; 8: 115-126
        View in Article
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        View in Article

      Article info

      Publication history

      Published online: February 10, 2017
      Accepted: February 5, 2017
      Received in revised form: January 25, 2017
      Received: December 12, 2016

      Identification

      DOI: https://doi.org/10.1016/j.ejim.2017.02.003

      Copyright

      © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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