Internal Medicine Service 'Los Montalvos', University Hospital, Salamanca, Spain.
Int J Clin Pract. 2013 Mar;67(3):282-9. doi: 10.1111/j.1742-1241.2012.02982.x.
The aim of the work was to analyse the outpatient medication errors detected on admission in senior patients in a Spanish general internal medicine service.
We carried out a retrospective cohort study based on a review of the admission reports of consecutive, non-selected, patients aged ≥ 65 years.
Eight hundred and sixty admission reports (cases) were analysed. Overall, we detected 218 errors in 173 (20.1%) of them. 'Wrong drug' errors were found in 165 occasions (75.7% of the 218 detected errors), being the most frequent among these 'not indicated/inappropriate drug for the diagnosis' (61 cases, 28.0%), followed by 'not indicated/inappropriate drug for the patient's condition' (55 cases, 25.2%). The binary logistic regression analysis showed association (p<0.05) between medication errors and sex (female) (OR 0.53, 95%, CI 0.37-0.76), cognitive impairment (OR 0.57, 95% CI 0.38-0.85), length of hospital stay (OR 1.06, 95% CI 1.00-1.11), number of diagnoses (OR 0.92, 95% CI 0.85-0.98), number of medicines at admission (OR 1.20, 95% CI 1.13-1.28) and lack of a recent previous admission in an internal medicine department (OR 2.07, 95% CI 1.14-3.74).
Although previous studies are not completely comparable, the incidence of errors found at admission in our study is low. We stress the relevance of the reconciliation of treatment in elderly people (where internists may play an important role, from their perspective of a comprehensive patient's care) and integrated procedures for medication prescription and dispensation.
本研究旨在分析西班牙某综合内科门诊老年患者入院时发现的门诊用药错误。
我们进行了一项回顾性队列研究,对连续、非选择性、年龄≥65 岁的患者的入院报告进行了回顾。
共分析了 860 份入院报告(病例)。总体而言,我们在 173 例(20.1%)患者中发现了 218 例错误。165 例(218 例检出错误中的 75.7%)存在“用药错误”,其中最常见的是“诊断用药不当/不合适”(61 例,28.0%),其次是“患者病情用药不当/不合适”(55 例,25.2%)。二元逻辑回归分析显示,用药错误与性别(女性)(OR 0.53,95%CI 0.37-0.76)、认知障碍(OR 0.57,95%CI 0.38-0.85)、住院时间(OR 1.06,95%CI 1.00-1.11)、诊断数量(OR 0.92,95%CI 0.85-0.98)、入院时用药数量(OR 1.20,95%CI 1.13-1.28)和内科住院史(OR 2.07,95%CI 1.14-3.74)有关(p<0.05)。
尽管先前的研究不完全具有可比性,但我们的研究中入院时发现的错误发生率较低。我们强调了在老年人中进行治疗核对(内科医生可能从全面的患者护理角度发挥重要作用)和药物处方与配药综合程序的重要性。