Tags

Type your tag names separated by a space and hit enter

An evaluation of the epidemiology of medication discrepancies and clinical significance of medicines reconciliation in children admitted to hospital.
Arch Dis Child 2016; 101(1):67-71AD

Abstract

AIMS

To determine the incidence of unintended medication discrepancies in paediatric patients at the time of hospital admission; evaluate the process of medicines reconciliation; assess the benefit of medicines reconciliation in preventing clinical harm.

METHOD

A 5 month prospective multisite study. Pharmacists at four English hospitals conducted admission medicines reconciliation in children using a standardised data collection form. A discrepancy was defined as a difference between the patient's preadmission medication (PAM), compared with the initial admission medication orders written by the hospital doctor. The discrepancies were classified into intentional and unintentional discrepancies. The unintentional discrepancies were assessed for potential clinical harm by a team of healthcare professionals, which included doctors, pharmacists and nurses.

RESULTS

Medicines reconciliation was conducted in 244 children admitted to hospital. 45% (109/244) of the children had at least one unintentional medication discrepancy between the PAM and admission medication order. The overall results indicated that 32% (78/244) of patients had at least one clinically significant unintentional medication discrepancy with potential to cause moderate 20% (50/244) or severe 11% (28/244) harm. No single source of information provided all the relevant details of a patient's medication history. Parents/carers provided the most accurate details of a patient's medication history in 81% of cases.

CONCLUSIONS

This study demonstrates that in the absence of medicines reconciliation, children admitted to hospitals across England are at risk of harm from unintended medication discrepancies at the transition of care from the community to hospital. No single source of information provided a reliable medication history.

Authors+Show Affiliations

Centre for Paediatric Pharmacy Research, UCL School of Pharmacy, London, UK Academic Practice Unit, Pharmacy, Birmingham Children's Hospital, Birmingham, UK.Department of Pharmacy, Evelina Children's Hospital, King's Health Partners, London, UK.Centre for Paediatric Pharmacy Research, UCL School of Pharmacy, London, UK Department of Pharmacy, University College London Hospitals NHS Foundation Trust, London, UK.Neurosurgery Department, Birmingham Children's Hospital, Birmingham, UK.Department of Pharmacy, University Hospitals of North Midlands NHS Trust, Staffordshire, UK.Department of Pharmacy, Leeds Children's Hospital, Leeds Teaching Hospital NHS Trust, Leeds, UK.Department of Pharmacy, Leeds Children's Hospital, Leeds Teaching Hospital NHS Trust, Leeds, UK.Academic Practice Unit, Pharmacy, Birmingham Children's Hospital, Birmingham, UK.School of Pharmacy, Aston University, Birmingham, UK.Centre for Paediatric Pharmacy Research, UCL School of Pharmacy, London, UK Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, China.Academic Practice Unit, Pharmacy, Birmingham Children's Hospital, Birmingham, UK School of Pharmacy, Aston University, Birmingham, UK.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26566687

Citation

Huynh, Chi, et al. "An Evaluation of the Epidemiology of Medication Discrepancies and Clinical Significance of Medicines Reconciliation in Children Admitted to Hospital." Archives of Disease in Childhood, vol. 101, no. 1, 2016, pp. 67-71.
Huynh C, Tomlin S, Jani Y, et al. An evaluation of the epidemiology of medication discrepancies and clinical significance of medicines reconciliation in children admitted to hospital. Arch Dis Child. 2016;101(1):67-71.
Huynh, C., Tomlin, S., Jani, Y., Solanki, G. A., Haley, H., Smith, R. E., ... Terry, D. (2016). An evaluation of the epidemiology of medication discrepancies and clinical significance of medicines reconciliation in children admitted to hospital. Archives of Disease in Childhood, 101(1), pp. 67-71. doi:10.1136/archdischild-2015-308591.
Huynh C, et al. An Evaluation of the Epidemiology of Medication Discrepancies and Clinical Significance of Medicines Reconciliation in Children Admitted to Hospital. Arch Dis Child. 2016;101(1):67-71. PubMed PMID: 26566687.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An evaluation of the epidemiology of medication discrepancies and clinical significance of medicines reconciliation in children admitted to hospital. AU - Huynh,Chi, AU - Tomlin,Stephen, AU - Jani,Yogini, AU - Solanki,Guirish A, AU - Haley,Helen, AU - Smith,Rachel E, AU - Lowey,Andrew, AU - Sinclair,Anthony, AU - Wilson,Keith A, AU - Wong,Ian Chi Kei, AU - Terry,David, Y1 - 2015/11/13/ PY - 2015/03/13/received PY - 2015/10/18/accepted PY - 2015/11/15/entrez PY - 2015/11/15/pubmed PY - 2016/4/12/medline KW - Epidemiology KW - Health services research SP - 67 EP - 71 JF - Archives of disease in childhood JO - Arch. Dis. Child. VL - 101 IS - 1 N2 - AIMS: To determine the incidence of unintended medication discrepancies in paediatric patients at the time of hospital admission; evaluate the process of medicines reconciliation; assess the benefit of medicines reconciliation in preventing clinical harm. METHOD: A 5 month prospective multisite study. Pharmacists at four English hospitals conducted admission medicines reconciliation in children using a standardised data collection form. A discrepancy was defined as a difference between the patient's preadmission medication (PAM), compared with the initial admission medication orders written by the hospital doctor. The discrepancies were classified into intentional and unintentional discrepancies. The unintentional discrepancies were assessed for potential clinical harm by a team of healthcare professionals, which included doctors, pharmacists and nurses. RESULTS: Medicines reconciliation was conducted in 244 children admitted to hospital. 45% (109/244) of the children had at least one unintentional medication discrepancy between the PAM and admission medication order. The overall results indicated that 32% (78/244) of patients had at least one clinically significant unintentional medication discrepancy with potential to cause moderate 20% (50/244) or severe 11% (28/244) harm. No single source of information provided all the relevant details of a patient's medication history. Parents/carers provided the most accurate details of a patient's medication history in 81% of cases. CONCLUSIONS: This study demonstrates that in the absence of medicines reconciliation, children admitted to hospitals across England are at risk of harm from unintended medication discrepancies at the transition of care from the community to hospital. No single source of information provided a reliable medication history. SN - 1468-2044 UR - https://www.unboundmedicine.com/medline/citation/26566687/An_evaluation_of_the_epidemiology_of_medication_discrepancies_and_clinical_significance_of_medicines_reconciliation_in_children_admitted_to_hospital_ L2 - http://adc.bmj.com/cgi/pmidlookup?view=long&pmid=26566687 DB - PRIME DP - Unbound Medicine ER -