Discrepancy analysis of prescriptions for patients observed by the surgical clinic in a public hospital

Authors

DOI:

https://doi.org/10.33448/rsd-v10i7.16703

Keywords:

Medication Errors; Inappropriate Prescribing; Patient Safety; Drug-related side effects and adverse reactions.

Abstract

Health problems can be caused by improper use of medicines, in this context, a reconciliation of medicines is a process that aims to identify and compare medicines for home use to ensure a better treatment to the patient. In this context, the present study aimed to compare intentional and unintentional discrepancies found in patients prescriptions admitted to the surgical clinic of a public hospital. Through a structured interview, carried out before admission and compared with the prescriptions after admission. Discrepancies were classified as intentional and unintentional. In one hundred (100) patient patients, fifty-nine (59) independent discrepancies. Of these, the majority were female (68%), with a median age of 59 years. Of the fifty-seven (57) unintentional discrepancies found, 78.9% occurred by default, and 15.8% per dose. The intentional ones were sixty-six (66), being 84.9% by default, due to protocols prepared by the hospital. Thus, the study demonstrates a high rate of discrepancies found in patients, suggesting the importance of implementing a pharmacist reconciliation that reduces the number of problems related to pharmacotherapy, to ensure patient safety.

References

Anacleto, T. A., Rosa, M. B., Neiva, H. M. & Martins, M. A. P. (2010). Erros de medicação. Pharm Bras, 7–8.

Bandres, M. A. A., Mendoza, M. A., Nicolás, F. G., Hernandez, M. A. C. & La Iglesia, F. R. (2013). Pharmacist-led medication reconciliation to reduce discrepancies in transitions of care in Spain. Int J Clin Pharm, 35(6), 1083–90.

Barnes, M. P. & Bloom, B. (2008). Complementary and Alternative Medicine Use Among Adults and Children: United States.

Beckett, R. D., Crank, C. W. & Wehmeyer, A. (2012). Effectiveness and feasibility of pharmacist-led admission medication reconciliation for geriatric patients. J Pharm Pract, 25(2), 136–41.

Bodenheimer, T. (2008). Coordinating Care - A Perilous Journey through the Health Care System. N Engl J Med, 358(10), 1064–71.

Coleman, E. A. & Berenson, R. A. (2004). Lost in transition: Challenges and opportunities for improving the quality of transitional care. Ann Intern Med, 141(7), 533–6.

Coleman, E. A., Smith, J. D., Raha, D. & Min, S. (2005). Posthospital Medication Discrepancies. Arch Intern Med, 165(16), 1842.

Cornish, P. L., Knowles, S. R., Marchesano, R., Tam, V., Shadowitz, S., Juurlink, D. N. & Etchells, E. E. (2005). Unintended Medication Discrepancies at the Time of Hospital Admission. Arch Intern Med, 165(4), 424–9.

Davies, E. C., Green, C. F., Taylor, S., Williamson, P. R., Mottram, D. R. & Pirmohamed, M. (2009). Adverse drug reactions in hospital in-patients: A prospective analysis of 3695 patient-episodes. PLoS One, 4(2).

Djuv, A., Nilsen, O. G. & Steinsbekk, A. (2013). The co-use of conventional drugs and herbs among patients in Norwegian general practice: A cross-sectional study. BMC Complement Altern Med, 13.

Ferreira, F. S., Pereira, T. A., Souza, B. P., Sanches, A. C. C. (2021). O papel do farmacêutico na prevenção de erros de medicação. Research, Society and Development, 10(3).

Fitzgerald, R. J. (2009). Medication errors: The importance of an accurate drug history. Br J Clin Pharmacol, 67(6), 671–5.

Flores, L. M. & Mengue, S. S. (2005). Uso de medicamentos por idosos em região do sul do Brasil. Rev Saude Publica, 39(6), 924–9.

Gleason, K. M., McDaniel, M. R., Feinglass, J., Baker, D. W., Lindquist, L., Liss, D. & Noskin, G. A. (2010) Results of the medications at transitions and clinical handoffs (match) study: An analysis of medication reconciliation errors and risk factors at hospital admission. J Gen Intern Med. 25(5):441–7.

Hayes, B. D, Donovan, J. L., Smith, B.S. & Hartman, C. A. (2007). Pharmacist-conducted medication reconciliation in an emergency department. Am J Heal Pharm, 64(16), 1720–3.

Hias, J., Van der Linden, L., Spriet, I., Vanbrabant, P., Willems, L., Tournoy, J. & Winter, S. (2017). Predictors for unintentional medication reconciliation discrepancies in preadmission medication: a systematic review. Eur J Clin Pharmacol, 73(11),1355–77.

Johnston, R., Saulnier, L. & Gould, O. (2010). Best possible medication history in the emergency department: Comparing pharmacy technicians and pharmacists. Can J Hosp Pharm, 63(5), 359–65.

Kiechle, E. S., McKenna, C. M., Carter, H., Zeymo, A., Gelfand, B. W., DeGeorge, L. M., Sauter, D. A. & Mazer-Amirshahi, M. (2018). Medication Allergy and Adverse Drug Reaction Documentation Discrepancies in an Urban, Academic Emergency Department. J Med Toxicol, 14(4), 272–7.

Kwan, J. L., Lo, L., Sampson, M. & Shojania, K.G. (2013). Medication Reconciliation During Transitions of Care as a Patient Safety Strategy A Systematic Review The Problem. 158(5), 397.

Lehnbom, E. C., Stewart, M. J., Manias, E. & Westbrook, J. I. (2014). Impact of Medication Reconciliation and Review on Clinical Outcomes. Ann Pharmacother, 48(10), 1298–312.

Lombardi, N. F., Mendes, A. E. M., Lucchetta, R. C., Reis, W. C. T., Fávero, M. L. D. & Correr, C. J. (2016). Análise das discrepâncias encontradas durante a conciliação medicamentosa na admissão de pacientes em unidades de cardiologia: Um estudo descritivo. Rev Lat Am Enfermagem, 24.

Marinho, V., Laks, J., Coutinho, E. S. F. & Blay, S. L. (2010). Tobacco use among the elderly: a systematic review and meta-analysis. Cad Saude Publica, 26(12), 2213–33.

Mendes, A. E., Lombardi, N. F., Andrzejevski, V. S., Frandoloso, G., Correr C. J. & Carvalho M. (2016). Medication reconciliation at patient admission: A randomized controlled trial. Pharm Pract (Granada), 14(1), 1–7.

Moriel, M. C., Pardo, J., Catalá, R. M. & Segura, M. (2008). Prospective study on conciliation of medication in orthopaedic patients. Farm, 32(2), 65–70.

Nagao-Dias, A. T., Barros-Nunes, P., Coelho, H. L. L & Solé, D. (2004). Reações alérgicas a medicamentos. J Pediatr (Rio J), 80(4), 259–66.

Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia da Pesquisa Científica. UFSM.

Pippins, J. R., Gandhi, T. K., Hamann, C., Ndumele, C. D., Labonville, S. A., Diedrichsen, E. K., Carty, M. G., Karson, A. S., Bhan, I., Coley, C. M., Liang, C. L., Turchin, A., McCarthy, P. C. & Schnipper, J. L. (2008). Classifying and predicting errors of inpatient medication reconciliation. J Gen Intern Med, 23(9), 1414-22.

Rozich, J. D., Howard, R. J., Justeson, J. M., Macken, P. D., Lindsay, M. E. & Resar, R. K. (2004). Standardization as a mechanism to improve safety in health care. Jt Comm J Qual Saf, 30(1):5–14.

Salanitro, A. H., Osborn, C. Y., Schnipper, J. L., Roumie, C. L., Labonville, S., Johnson, D. C., Neal, E., Cawthon, C., Businger, A., Dalal, A. K. & Kripalani, S. (2012). Effect of patient- and medication-related factors on inpatient medication reconciliation errors. J Gen Intern Med, 27(8), 924–32.

Silva de Sousa, M., Muniz, J. M., Cordeiro Silva, S., Fornari, J. V., Sena Barnabé, A., Barbosa de Deus, R. & Ferraz, R. R. N. (2012). Indicações e Tempo de Permanência em Internação Pós-Cirúrgica em um Hospital Público da Cidade de São Paulo - SP. Rev Gestão em Sist Saúde, 01(01), 108–15.

Silva, E. F., Laste, G., Torres, R. L., Hidalgo, M. P. L., Stroher, R. & Torres, I. L. S. (2017). Consumo de álcool e tabaco: fator de risco para doença cardiovascular em população idosa do sul do Brasil. Saúde e Desenvolv Hum, 5(1), 23.

Sousa, P. & Mendes, W. (2014). Segurança do paciente: conhecendo os riscos nas organizações de saúde. Fundação Oswaldo Cruz. Editora Fiocruz.

Tran, T., Taylor, S. E., Hardidge, A., Mitri, E., Aminian, P., George, J. & Elliott, R. A. (2019). The Prevalence and Nature of Medication Errors and Adverse Events Related to Preadmission Medications When Patients Are Admitted to an Orthopedic Inpatient Unit: An Observational Study. Ann Pharmacother, 53(3), 252–60.

Van Der Luit, C. D. E., De Jong, I. R., Ebbens, M. M., Euser, S., Verweij, S. L., Van Den Bemt, P. M. L. A., Luttikhuis, H. M. & Becker, M. L. (2018). Frequency of occurrence of medication discrepancies and associated risk factors in cases of acute hospital admission. Pharm Pract (Granada), 16(4), 1–5.

Vira, T., Colquhoun, M. & Etchells, E. (2006). Reconcilable differences: Correcting medication errors at hospital admission and discharge. Qual Saf Heal Care, 15(2), 122–6.

WHO - World Health Organization (2002). Policy Perspectives on Medicines - Promoting rational use of medicines: core components. World Heal Organ. http://archives.who.int/tbs/rational/h3011e.pdf

WHO - World Health Organization. Collaborating (2020) Centre for Drugs Statistics Methodology. Anatomical Therapeutic Chemical Classification (ATC Code). https://www.whocc.no/atc_ddd_index/

Zoni, A. C., Durán García, M. E., Jiménez Muñoz, A. B., Salomón Pérez, R., Martin, P. & Herranz Alonso, A. (2012). The impact of medication reconciliation program at admission in an internal medicine department. Eur J Intern Med, 23(8), 696–700.

Published

29/06/2021

How to Cite

BALDIN, S. R. .; FERREIRA, F. S.; OLIOTA, A. F. R. .; GIORDANI, F.; SOUSA, P. G. de .; CALDEIRA, L. de F.; SANCHES, A. C. C. . Discrepancy analysis of prescriptions for patients observed by the surgical clinic in a public hospital. Research, Society and Development, [S. l.], v. 10, n. 7, p. e47010716703, 2021. DOI: 10.33448/rsd-v10i7.16703. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/16703. Acesso em: 25 nov. 2024.

Issue

Section

Health Sciences