Risk of prescribing errors in acutely admitted patients: a pilot study

Int J Clin Pharm. 2016 Oct;38(5):1157-63. doi: 10.1007/s11096-016-0345-y. Epub 2016 Jul 9.

Abstract

Background Prescribing errors in emergency settings occur frequently. Knowing which patients have the highest risk of errors could improve patient outcomes. Objective The aim of this study was to test an algorithm designed to assess prescribing error risk in individual patients, and to test the feasibility of medication reviews in high-risk patients. Setting The study was performed at the Acute Admissions Unit at Aarhus University Hospital, Denmark. Methods The study was an interventional pilot study. Patients included were assessed according to risk of prescribing errors with the aid of an algorithm called 'Medication Risk Score' (MERIS). Based on the score, high-risk patients were offered a medication review. The clinical relevance of the medication reviews was assessed retrospectively. Main outcome measure The number and nature of prescribing errors during the patients' hospitalisation. Results The study included 103 patients, all of whom could be risk assessed with the algorithm MERIS. MERIS stratified 38 patients as high-risk patients and 65 as low-risk patients. The 103 patients were prescribed a total of 848 drugs in which 88 prescribing errors were found (10.4 %). Sixty-two of these were found in patients in the high-risk group. In general, the medication reviews were found to be clinically relevant and approximately 50 % of recommendations were implemented. Conclusion MERIS was found to be applicable in a clinical setting and stratified most patients with prescribing errors into the high-risk group. The medication reviews were feasible and found to be clinically relevant by most raters.

Keywords: Acute admissions unit; Denmark; Medication reviews; Medication risk score; Prescribing errors.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Drug Prescriptions / standards*
  • Drug Utilization Review / standards*
  • Drug Utilization Review / trends
  • Female
  • Hospitalization / trends
  • Humans
  • Male
  • Medication Errors / prevention & control*
  • Medication Errors / trends
  • Middle Aged
  • Patient Admission / standards*
  • Patient Admission / trends
  • Pharmacy Service, Hospital / standards*
  • Pharmacy Service, Hospital / trends
  • Pilot Projects
  • Risk Factors
  • Young Adult