AN EPIDEMIOLOGICAL STUDY OF MEDICATION RECONCILIATION AND MEDICATION ERRORS IN SECONDARY CARE

Dr. Are. Anusha*, Paavan Kumar K., Nagesh N. and Aamani S. 

ABSTRACT

Background: A medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient or consumer. Medication process involves 5 broad stages: Prescription, administration, transcription, monitoring, dispensing. medication errors, defined as any error in the medication process regardless of whether a patient experiences an adverse consequence, can occur at any step. Medication reconciliation is the process of creating the most accurate list possible of all medications a patient is taking including drug name, dosage, frequency and route and comparing that list against the physicians admission, transfer, and/or discharge orders, with the goal of providing the correct medications to the patient at all transition points with in the hospital. Aim: An Epidemiological study of Medication Reconciliation and Medication Errors in Secondary. Care Hospitals. Methodology: Multi-center, prospective, observational study, a total of 187 cases with medication errors were taken and analysed. Results: A total of 187 cases having medication errors were evaluated among which medication reconciliation process was assessed whether obtained or not. Results showed in 51 cases medication reconciliation was not taken and in 136 cases it was taken, out of which only illness history was taken for 44 cases, both illness history and drugs were taken for 32 cases(23.52%) and in 60 cases there was no significant past illness in the patient. Out of 136 cases where medication reconciliation was obtained, hypertension condition was found in 33 cases, type2 diabetis mellitus in 27 cases. Here we are mainly concentrating on prescribing errors and administration errors. Out of 187 cases 327 errors were found. In that 320 medication errors were prescribing errors and remaining were administration. In that 320 prescribing medication errors, wrong/no indication accounted for 179errors (55.93%) ranking at first and actual drug-drug interactions which affect the patient were seen in 1 case accounting for least number. drugs which are inappropriately prescribed causing medication errors. Out of 187 cases ceftriaxone was inappropriately prescribed in 72 cases (31.85%) ranking first, erythromycin(0.44%), linezolide(0.44%), and fluconazole(0.44%) are used one in each case accounting last ranked drugs. Mild category accounted for 180 cases(96.25%) followed by moderate 7 cases(3.74) and there were no case under severe category. there were 167 cases(89.30%) with significant category followed by 9 cases of hospitalised & serious medication error each. there were no life threatening and fatal medication errors. Conclusion: Most of the errors are clinically significant and it can be prevented by working together in a healthcare team. We experienced that most of the medication error was mainly due to poor prescription writing. Clinical Pharmacist can play major role in the early detection and prevention of medication errors and thus can improve the quality of care to the patients. This study clearly shows the need for a clinical pharmacist to work full-time at the Medicine ward and to develop Hospital formulary, drug protocols and prescription policies in the hospital, ward-based clinical pharmacist can prevent negative consequences related to medications. This study recommends the need for additional resources and educational initiatives for the health care professionals to improve medication reconciliation. results are evident for the need of medication reconciliation and participation of clinical pharmacist in the pharmaceutical care plan for minimizing the medication errors.

Keywords: A medication error is any minimizing the medication errors.