Unintentional medication discrepancies and postoperative adverse drug events in ...

연구 요약

Unintentional medication discrepancies and postoperative adverse drug events in patients with cancer: A prospective cohort study.

British journal of clinical pharmacology 학술지에 발표된 이 연구는 Mehrabifar A, Manias E, Poulton T 외 연구팀이 수행하였습니다.

이 연구는 'Unintentional medication discrepancies and postoperative adverse drug events in patients with cancer: A prospective cohort study.'에 대한 과학적 분석을 제공합니다.

핵심 내용

AIM: To understand regular medication management processes in the postoperative period for patients having major cancer surgery, and to evaluate whether medication discrepancies were associated with postoperative adverse drug events (ADEs). METHOD: A prospective cohort of 500 adult patients, undergoing planned major cancer surgery at a Melbourne specialist cancer hospital, was followed from surgery to day 30 postoperatively. Regular medication discrepancies were assessed across transitions of care up to five days postoperatively and at discharge. Adverse drug events were monitored up to 30 days after surgery. Multivariable logistic regression was used to identify predictors of medication discrepancies and ADEs. RESULTS: Among 7254 medication orders for 500 patients, 12.5% (n = 905) of orders resulted in unintentional medication discrepancies. Polypharmacy (OR = 1.32; 95%CI: 1.21-1.44; p < 0.001) and length of stay (OR = 1.07; 95%CI: 1.03-1.12; p = 0.001) were significant predictors of unintentional medication discrepancies. ADEs occurred in 16.4% of patients (n = 82). In multivariable analysis, the odds of experiencing an ADE were significantly higher among patients who had unintentional discrepancies (vs. those with intentional discrepancies; OR = 3.06; 95%CI: 1.66-5.64; p < 0.001), older age (OR = 1.05; 95%CI: 1.02-1.08; p < 0.001), polypharmacy (OR = 1.20; 95%CI: 1.08-1.33; p < 0.001), higher acuity care admission (OR = 2.46; 95%CI: 1.33-4.54; p = 0.004) and prolonged hospital length of stay (OR = 1.07; 95%CI: 1.02-1.12; p = 0.002). Cardiovascular and alimentary tract medications were most commonly implicated in both discrepancies and ADEs. CONCLUSION: Unintentional medication discrepancies are associated with postoperative ADEs in patients having cancer surgery. Targeted strategies-especially for older patients, those with polypharmacy, and extended hospital stays-are essential to enhance medication safety across perioperative transitions.

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