Abstract
Background
Medication errors lead to morbidity and mortality among emergency department (ED)
patients. An inaccurate medication history is one of the underlying causes of these
errors.
Objectives
This study was performed to determine the prevalence of patients with discrepancies
between the medical list information contained in the clinical history compiled on
admission to the ED and the list of medications patients are actually taking, to characterize
the discrepancies found, and to analyze whether certain factors are associated with
the risk of discrepancies.
Methods
We conducted a cross-sectional, descriptive, observational, multicenter study with
an analytic component in the EDs of 11 hospitals in Spain. We compared pharmacist-obtained
medication lists (PML) with ED-obtained medication lists (EDML). Discrepancy was defined
as one or more differences (in drug or dosage or route of administration) between
the EDML and PML. The endpoints were the proportion of patients with discrepancies
in their home medical lists, and the prevalence of certain factors among patients
with discrepancies and those without.
Results
We detected 1476 discrepancies in 387 patients; no discrepancies were found in 20.7%.
The most frequent discrepancies involved incomplete information (44.2%) and omission
(41.8%). In the bivariate analysis, age, number of medications, and Charlson comorbidity
score were significantly associated with discrepancy. In the multivariate analysis,
number of medications and hospital were the variables associated with discrepancy.
Conclusions
The EDML differed from the list of medications patients were actually taking in 79.3%
of cases. Incomplete information and omission were the most frequent discrepancies.
Age, number of medications, and comorbidities were related to the risk of discrepancies.
Keywords
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Article info
Publication history
Published online: December 26, 2014
Accepted:
June 30,
2014
Received in revised form:
May 22,
2014
Received:
November 5,
2013
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
