Highlights
- •Nephrology transplant outpatients use on average ten medications
- •Medication transfer errors are found in 62% of nephology outpatients.
- •The number of medications in use is associated with the occurrence of errors.
- •71% of the medication transfer errors have the potential to cause harm.
Abstract
Background
Medication reconciliation in transitions of care can prevent medication transfer errors
(MTE). MTE can cause patient harm. Since performing medication reconciliation for
every patient is not always feasible, identification of potential risk factors of
MTE could aid in targeting this intervention to the right patients.
Objective
To establish the proportion of patients with one or more MTE in the outpatient nephrology
setting. Secondary patient characteristics associated with MTE, type and potential
harm, and medication groups were investigated.
Methods
This retrospective observational cohort study was conducted in the Leiden University
Medical Center, the Netherlands, between November 2017 and April 2018. The cohort
involved patients in whom medication reconciliation was performed by a medical attendant
using the electronic tool ‘Medical Dashboard’ prior to visiting the nephrologist.
MTE were defined as unintended discrepancies between the medication in the hospital
system and the result of the medication reconciliation. The proportion of patients
with one or more MTE was calculated and the association of patient characteristics
(age, sex, number of medications and kidney function (CKD-EPI)) with MTE was analyzed
using multivariate logistic regression.
Results
Of 380 patients, 235 patients (61.8%) had at least one MTE. On average patients used
10.3 medications. The number of medications per patient was significantly associated
with MTE; OR 1.11 (95%CI 1.05–1.16). No association was found for age, sex, and kidney
function.
Conclusion
In ambulatory nephrology patients 61.8% had at least one MTE. Nephrology patients
using a higher number of drugs are more prone to MTE.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to European Journal of Internal MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Frequency, type and clinical importance of medication history errors at admission to hospital: a systematic review.CMAJ. 2005; 173: 510-515
- Predictors for unintentional medication reconciliation discrepancies in preadmission medication: a systematic review.Eur J Clin Pharmacol. 2017; 73: 1355-1377
- Impact of electronic medication reconciliation interventions on medication discrepancies at hospital transitions: a systematic review and meta-analysis.BMC Med Inform Decis Mak. 2016; 16: 112
- Impact of admission medication reconciliation performed by clinical pharmacists on medication safety.Eur J Intern Med. 2014; 25: 808-814
- (Cited 07 May. Available from)
- An evaluation of medication reconciliation at an outpatient internal medicines clinic.Eur J Intern Med. 2017; 44: e32-e34
- Ambulatory medication reconciliation in dialysis patients: benefits and community Practitioners' Perspectives.Can J Hosp Pharm. 2017; 70 ([Epub 2017 Dec 21]): 443-449
- An evaluation of medication reconciliation in an outpatient nephrology clinic.CANNT J. 2017; 26: 29-33
- Results of the medications at transitions and clinical handoffs (MATCH) study: an analysis of medication reconciliation errors and risk factors at hospital admission.J Gen Intern Med. 2010; 25 ([Epub 2010 Feb 24]): 441-447https://doi.org/10.1007/s11606-010-1256-6
- Identifying discrepancies in electronic medical records through pharmacist medication reconciliation.J Am Pharm Assoc (2003). 2012; 52: 59-66https://doi.org/10.1331/JAPhA.2012.10123
National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP). Types of Medication Errors. NCCMERP National Coordinating Council for Medication Error Reporting an Prevention, 20011996. 2001 http://www.nccmerp.org/types-medication-errors. Updated . .
- Pharmacy-led medication reconciliation programmes at hospital transitions: a systematic review and meta-analysis.J Clin Pharm Ther. 2016; 41: 128-144
Article info
Publication history
Published online: October 09, 2019
Accepted:
September 9,
2019
Received in revised form:
September 6,
2019
Received:
May 13,
2019
Identification
Copyright
© 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
