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Medication discrepancies at discharge from an internal medicine service.
Eur J Intern Med 2011; 22(1):43-8EJ

Abstract

BACKGROUND

Medication errors most commonly occur at the time of medication prescribing and particularly at the moment of the transitions of care. The objectives of this study were to identify and characterize the discrepancies between the physicians' discharge medication orders and the medication lists at admission obtained by an internal medicine specialist physician in a general internal medicine service.

METHODS

This descriptive, retrospective, study was carried out at a tertiary care university teaching hospital in Spain. It was based on the review of non selected, consecutive, hospital discharge reports. Discrepancies were identified, categorized and characterized through the analysis of the information (medication lists, laboratory tests results, diagnosis, and clinical evolution) contained in them.

RESULTS

We analyzed 954 discharge reports. In the medication reconciliation process, we find discrepancies in 832 (87.2%) of them. Justified discrepancies were found in 828 (86.8%) reports and unjustified discrepancies in 52 (5.4%). Omission of a medication was the most frequent medication error detected in 86.4% of cases, followed by incomplete prescription (9.6%). The number of diagnosis, the length of hospital stay and the number of permanent medications at admission were the characteristics of cases associated with medication discrepancies in multivariate linear regression (P<0.01).

CONCLUSIONS

Although considering the limitations in its design, it is remarkable the low number of medication errors detected in our study. Appropriate routines to ensure an accurate medication history collection and a methodical elaboration of the medication list at discharge, when performed by trained internists, are important for an adequate medication reconciliation process.

Authors+Show Affiliations

Service of Internal Medicine-Los Montalvos, University Hospital of Salamanca, Los Montalvos s/n, 37192 Salamanca, Spain. jherreroh@saludcastillayleon.esNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

21238892

Citation

Herrero-Herrero, José-Ignacio, and Judit García-Aparicio. "Medication Discrepancies at Discharge From an Internal Medicine Service." European Journal of Internal Medicine, vol. 22, no. 1, 2011, pp. 43-8.
Herrero-Herrero JI, García-Aparicio J. Medication discrepancies at discharge from an internal medicine service. Eur J Intern Med. 2011;22(1):43-8.
Herrero-Herrero, J. I., & García-Aparicio, J. (2011). Medication discrepancies at discharge from an internal medicine service. European Journal of Internal Medicine, 22(1), pp. 43-8. doi:10.1016/j.ejim.2010.10.003.
Herrero-Herrero JI, García-Aparicio J. Medication Discrepancies at Discharge From an Internal Medicine Service. Eur J Intern Med. 2011;22(1):43-8. PubMed PMID: 21238892.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Medication discrepancies at discharge from an internal medicine service. AU - Herrero-Herrero,José-Ignacio, AU - García-Aparicio,Judit, Y1 - 2010/11/11/ PY - 2010/08/21/received PY - 2010/10/10/revised PY - 2010/10/13/accepted PY - 2011/1/18/entrez PY - 2011/1/18/pubmed PY - 2011/5/14/medline SP - 43 EP - 8 JF - European journal of internal medicine JO - Eur. J. Intern. Med. VL - 22 IS - 1 N2 - BACKGROUND: Medication errors most commonly occur at the time of medication prescribing and particularly at the moment of the transitions of care. The objectives of this study were to identify and characterize the discrepancies between the physicians' discharge medication orders and the medication lists at admission obtained by an internal medicine specialist physician in a general internal medicine service. METHODS: This descriptive, retrospective, study was carried out at a tertiary care university teaching hospital in Spain. It was based on the review of non selected, consecutive, hospital discharge reports. Discrepancies were identified, categorized and characterized through the analysis of the information (medication lists, laboratory tests results, diagnosis, and clinical evolution) contained in them. RESULTS: We analyzed 954 discharge reports. In the medication reconciliation process, we find discrepancies in 832 (87.2%) of them. Justified discrepancies were found in 828 (86.8%) reports and unjustified discrepancies in 52 (5.4%). Omission of a medication was the most frequent medication error detected in 86.4% of cases, followed by incomplete prescription (9.6%). The number of diagnosis, the length of hospital stay and the number of permanent medications at admission were the characteristics of cases associated with medication discrepancies in multivariate linear regression (P<0.01). CONCLUSIONS: Although considering the limitations in its design, it is remarkable the low number of medication errors detected in our study. Appropriate routines to ensure an accurate medication history collection and a methodical elaboration of the medication list at discharge, when performed by trained internists, are important for an adequate medication reconciliation process. SN - 1879-0828 UR - https://www.unboundmedicine.com/medline/citation/21238892/Medication_discrepancies_at_discharge_from_an_internal_medicine_service_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0953-6205(10)00210-4 DB - PRIME DP - Unbound Medicine ER -