Contribution of Renal Impairment to Potentially Preventable Medication-Related Hospital Admissions

Abstract

Medication errors and renal impairment contribute to severe adverse drug events, which may lead to hospital admission. To determine whether medication errors and renal impairment contribute to hospital admission and examine these errors for strategies to prevent admissions. The 714 medication-related hospital admissions reported in the prospective multicenter study HARM (Hospital Admissions Related to Medication) were analyzed. The patients were divided into 3 groups based on the availability of creatinine levels: group A, the home-monitored group (n = 227); group B, the hospital-monitored group (n = 420); and group C, the unmonitored group (n = 67). After assessment, 70 admissions (10%) were considered to be related to a medication error and renal impairment (A, 29; B, 41; C, none). In these 70 patients, 85 errors occurred in group A, 66 errors in group B, and none in group C. Dosing errors were identified in 46 patients (A, 14; B, 32), a drug-drug interaction in 22 patients (A, 13; B, 9), and a drug-disease interaction in 17 patients (A, 10; B, 7). Renal impairment and medication errors may lead to medication-related hospital admissions. Monitoring renal function and adjusting pharmacotherapy according to renal function might help to prevent hospital admissions. This can be a strategy for research on how to decrease the number of medication-related hospital admissions.