Unintentional medication discrepancies at care transitions: prevalence and their impact on post-discharge emergency visits in critically ill older adults.

Autor: Park J; College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, 1, Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea.; Department of Pharmacy, Seoul National University Hospital, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea., Kim AJ; Department of Pharmacy, Seoul National University Hospital, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea., Cho EJ; Department of Pharmacy, Seoul National University Hospital, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea., Cho YS; Department of Pharmacy, Seoul National University Hospital, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea., Jun K; College of Pharmacy, Gyeongsang National University, 501, Jinju-daero, Jinju-si, Gyeongsangnam-do, 52828, Republic of Korea., Jung YS; Department of Critical Care Medicine, Seoul National University Hospital, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea., Lee JY; College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, 1, Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea. jypharm@snu.ac.kr.; Department of Pharmacy, Seoul National University Hospital, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. jypharm@snu.ac.kr.
Jazyk: angličtina
Zdroj: BMC geriatrics [BMC Geriatr] 2024 Dec 18; Vol. 24 (1), pp. 1000. Date of Electronic Publication: 2024 Dec 18.
DOI: 10.1186/s12877-024-05517-w
Abstrakt: Background: Unintentional medication discrepancies during care transitions pose a significant risk for medication errors, particularly in critically ill older patients. This study aimed to investigate the prevalence of such discrepancies during care transitions and their impact on post-discharge emergency department (ED) visits in this patient population.
Methods: This retrospective cross-sectional study included patients aged 65 and older who were on chronic medications and admitted to the intensive care units of emergency departments (ED-ICUs) between 2019 and 2020. We evaluated unintentional medication discrepancies, including omissions or changes in medication type, dose, frequency, formulation, or administration route without clear clinical justification during care transition. The association between these discrepancies and post-discharge ED visits was analyzed using a multivariable Cox-proportional hazard model.
Results: Of the 339 patients analyzed, 68% encountered unintentional medication discrepancies at some point during care transitions, with prevalence of 35% at admission, 20% during transfer, and 49% at discharge. After adjusting for confounding factors, patients with unintentional medication discrepancies had a twofold higher risk of ED visits within 30 days of discharge (HR = 2.13, 95% CI = 1.06-4.30).
Conclusion: This study demonstrated a substantial prevalence of unintentional medication discrepancies among critically ill older adults during care transitions, significantly increasing the risk of ED visits within a month of discharge. The findings highlight the crucial need for systematic identification and management of medication discrepancies throughout the care transition process to enhance patient safety.
Competing Interests: Declarations. Ethics approval and consent to participate: The study protocol was reviewed and approved by the Institutional Review Board of Seoul National University Hospital (IRB No. H-2108–207-1249). The need for informed consent was waived by the Institutional Review Board because it is not practicable to obtain consent from patients for a retrospective review study. All methods were carried out in accordance with the declaration of Helsinki. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
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