Bilbao Gómez-Martino Cristina, Nieto Sánchez Ángel, Fernández Pérez Cristina, Borrego Hernando Mª Isabel, Martín-Sánchez Francisco Javier
Servicio de Farmacia, Hospital Clínico San Carlos, Madrid, España.
Servicio de Medicina Interna, Hospital Clínico San Carlos, Madrid. Universidad Complutense de Madrid, España.
Emergencias. 2017;29(6):384-390.
To study the frequency of medication reconciliation errors (MREs) in hospitalized patients and explore the profiles of patients at greater risk. To compare the rates of errors in prescriptions written by emergency physicians and ward physicians, who each used a different prescribing tool.
Prospective cross-sectional study of a convenience sample of patients admitted to medical, geriatric, and oncology wards over a period of 6 months. A pharmacist undertook the medication reconciliation report, and data were analyzed for possible associations with risk factors or prescriber type (emergency vs ward physician).
A total of 148 patients were studied. Emergency physicians had prescribed for 68 (45.9%) and ward physicians for 80 (54.1%). A total of 303 MREs were detected; 113 (76.4%) patients had at least 1 error. No statistically significant differences were found between prescriber types. Factors that conferred risk for a medication error were use polypharmacy (odds ratio [OR], 3.4; 95% CI, 1.2-9.0; P=.016) and multiple chronic conditions in patients under the age of 80 years (OR, 3.9; 95% CI, 1.1-14.7; P=.039).
The incidence of MREs is high regardless of whether the prescriber is an emergency or ward physician. The patients who are most at risk are those taking several medications and those under the age of 80 years who have multiple chronic conditions.
研究住院患者用药重整错误(MREs)的发生率,并探索高风险患者的特征。比较分别使用不同处方工具的急诊科医生和病房医生所开处方中的错误率。
对内科、老年科和肿瘤科病房6个月内收治的便利样本患者进行前瞻性横断面研究。由一名药剂师进行用药重整报告,并分析数据与风险因素或开处方者类型(急诊科医生与病房医生)之间的可能关联。
共研究了148例患者。急诊科医生为68例(45.9%)患者开了处方,病房医生为80例(54.1%)患者开了处方。共检测到303处用药重整错误;113例(76.4%)患者至少有1处错误。不同开处方者类型之间未发现统计学上的显著差异。导致用药错误风险增加的因素包括联合使用多种药物(比值比[OR],3.4;95%置信区间[CI],1.2 - 9.0;P = 0.016)以及80岁以下患有多种慢性病的患者(OR,3.9;95% CI,1.1 - 14.7;P = 0.039)。
无论开处方者是急诊科医生还是病房医生,用药重整错误的发生率都很高。风险最高的患者是服用多种药物的患者以及80岁以下患有多种慢性病的患者。