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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
      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.
      ]. 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.
      ,
      • Michel B.
      • Quelennec B.
      • Andres E.
      Medication reconciliation practices and potential clinical impact of unintentional discrepancies.
      ,
      • Wong J.D.
      • Bajcar J.M.
      • Wong G.G.
      • et al.
      Medication reconciliation at hospital discharge: evaluating discrepancies.
      ]. 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.
      ,
      • 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.
      ,
      • Pippins J.R.
      • Gandhi T.K.
      • Hamann C.
      • et al.
      Classifying and predicting errors of inpatient medication reconciliation.
      ,
      • Mixon A.S.
      • Myers A.P.
      • Leak C.L.
      • et al.
      Characteristics associated with postdischarge medication errors.
      ]. 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.
      ,
      • Mixon A.S.
      • Myers A.P.
      • Leak C.L.
      • et al.
      Characteristics associated with postdischarge medication errors.
      ,
      • 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.
      ]. Until this date, there are no case-control or cohort studies of risk factors for UMD.

      Keywords

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