Medication errors detected in elderly patients admitted to an internal medicine service

Abstract

The aim of the work was to analyse the outpatient medication errors detected on admission in senior patients in a Spanish general internal medicine service. We carried out a retrospective cohort study based on a review of the admission reports of consecutive, non-selected, patients aged ≥ 65 years. Eight hundred and sixty admission reports (cases) were analysed. Overall, we detected 218 errors in 173 (20.1%) of them. 'Wrong drug' errors were found in 165 occasions (75.7% of the 218 detected errors), being the most frequent among these 'not indicated/inappropriate drug for the diagnosis' (61 cases, 28.0%), followed by 'not indicated/inappropriate drug for the patient's condition' (55 cases, 25.2%). The binary logistic regression analysis showed association (p<0.05) between medication errors and sex (female) (OR 0.53, 95%, CI 0.37-0.76), cognitive impairment (OR 0.57, 95% CI 0.38-0.85), length of hospital stay (OR 1.06, 95% CI 1.00-1.11), number of diagnoses (OR 0.92, 95% CI 0.85-0.98), number of medicines at admission (OR 1.20, 95% CI 1.13-1.28) and lack of a recent previous admission in an internal medicine department (OR 2.07, 95% CI 1.14-3.74). Although previous studies are not completely comparable, the incidence of errors found at admission in our study is low. We stress the relevance of the reconciliation of treatment in elderly people (where internists may play an important role, from their perspective of a comprehensive patient's care) and integrated procedures for medication prescription and dispensation.