Abstract
BackgroundDrug-related problems due to medication errors are common and have the potential to cause harm. This study, which was conducted in Swedish primary health care, aimed to assess how well the medication lists in the medical records tally with the medications used by patients and to explore what type of medication errors are present.MethodsWe reviewed the electronic medical records (EMRs) at ten primary health care centers in Skåne county, Sweden. The medication lists in the EMRs were compared with the results of medication reconciliations, which were performed telephonically in a structured manner by a physician, two weeks after a follow-up visit to a general practitioner. Of 76 patients aged ≥18 years, who on a certain day in 2016 were visiting one of the included primary health care centers, a total of 56 were included. Descriptive statistics were used. The chi2-test and the Mann Whitney U-test were used for comparisons. The main outcome measure was the proportion of correctly updated medication lists.ResultsFollowing a recent visit to the general practitioner, a total of 16% of the medication lists in the medical records were consistent with the patients’ actual medication use. The mean number of medication errors in the medical records was 3.8 (SD 3.8). Incorrect dose was the most common error, followed by additional drugs without indication/documentation. The most common medication group among all errors was analgesics and among dose errors the most common medication group was cardiovascular drugs.ConclusionA total of 84% of the medication lists used by the general practitioners in the assessment and follow-up of the patients were not updated; this implies a great safety risk since medication errors are potentially harmful. Ensuring medication reconciliations in daily clinical practice is important for patient safety.
Highlights
Drug-related problems due to medication errors are common and have the potential to cause harm
In total 56 patients were included in the study, of whom 18 were aged ≥75 and 29 (52%) regularly visited a physician not working at the Primary care health center (PHC)
Among patients who exclusively visited the general practitioner (GP), a mean number of 2.4 (SD3.5) medication errors per list were identified and among those who visited a physician outside the PHC the mean number was 5.0 (SD3.5) (p = 0.001)
Summary
Drug-related problems due to medication errors are common and have the potential to cause harm. A review of the existing literature has shown that between 20 and 87% of patients encounter medication discrepancies upon discharge from hospital [13] and there was a correlation between the numbers of drugs a patient was on and the number of discrepancies; this correlation was identified in primary health care [14]. This implies that patients with multi-morbid conditions are at greater risk of medication discrepancies since they often receive more medicines. In Swedish primary health care, Ekedahl et al showed in 2012 that errors in the pharmaceutical and prescription lists are very common when comparing patient data with medical records and prescription database. Eight out of ten patients had at least one discrepancy between current drug use and the medication list [15]
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