A multicentre, prospective, observational study on detecting medication discrepa...

연구 요약

A multicentre, prospective, observational study on detecting medication discrepancies using medication reconciliation as a tool at the emergency department among geriatric patients in northwest Ethiopia.

BMJ open 학술지에 발표된 이 연구는 Moges TA, Zewdu WS, Yazie TS 외 연구팀이 수행하였습니다.

이 연구는 'A multicentre, prospective, observational study on detecting medication discrepancies using medication reconciliation as a tool at the emergency department among geriatric patients in northwest Ethiopia.'에 대한 과학적 분석을 제공합니다.

핵심 내용

OBJECTIVE: Geriatric patients often face issues related to polypharmacy and adverse drug events. Re-evaluating prescribed medications and considering deprescribing is critical. Medication discrepancies (MDs) during care transitions can compromise patient safety, as over 60% of medication errors occur at these points. This study aimed to assess the magnitude of MDs and their contributing factors through the medication reconciliation (MedRec) process among geriatric patients in emergency departments of comprehensive specialised hospitals in northwest Ethiopia, as well as to determine the acceptance of pharmaceutical interventions. DESIGN: In this multicentre prospective observational study, the best possible medication history (BPMH) was obtained within 24 hours of emergency department admission from at least two sources. A comparison of the BPMH list with medication orders from treating physicians revealed discrepancies. Data were analysed using STATA V.17.0, using multivariable logistic regression to assess variable associations. SETTING: Adult emergency departments of comprehensive specialised hospitals in northwest Ethiopia. PARTICIPANTS: Overall, 384 geriatric patients with chronic conditions and current medication use who visited the adult emergency department of the hospital from 10 January 2025 to 30 March 2025 were involved in this study. OUTCOME MEASURES: Magnitude and types of MDs, acceptance of pharmacist interventions, and factors associated with MDs. RESULTS: In total, 384 patients with chronic diseases visiting the hospital emergency department were recruited in the present study. Out of 384 patients involved in the study, 218 (56.77%) had encountered at least one MD. Omission error 190 (45.24%) was the most common type of MD, followed by wrong dose 82 (19.50%). Among 420 interventions, 80.48% of the total cases were accepted. Number of previous/home medications (≥5 medicines; adjusted OR (AOR)=3.12; 95% CI 1.190 to 8.151), older age (≥75 years; AOR=1.62; 95% CI 1.054 to 2.495), and number of comorbidities (≥3; AOR=1.65; 95% CI 1.066 to 2.546) were associated factors with MDs. CONCLUSION: This study revealed a high prevalence of MDs in the emergency department. Polypharmacy, comorbidities and older age were factors associated with MDs. The study findings show the need for a clinical pharmacist-led MedRec implementation to enhance patient safety.

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