Reducing medication errors, comparative effectiveness, and glucocorticosteroid dosing

Abstract

Reducing medication errors Murray et al.1 reported that pharmacist interventions to improve medication use in outpatients with cardiovascular disease decrease the risk of adverse drug events (ADEs) and medication errors. The multiclinic intervention was provided by specially trained pharmacists. Participants were dispensed medications in containers that enabled electronic monitoring of adherence to the prescribed cardiovascular medications and medication information designed for patients with low health literacy. A computer that was integrated into the electronic medical record system was used for monitoring prescription and nonprescription medications, tracking materials provided to patients, and documenting communications with patients, nurses, and physicians. Compared with the control group, the risk of any event was 34% lower in the intervention group (risk ratio 0.66 [95% CI 0.50–0.88]), including a lower risk of ADEs (0.65 [0.47–0.90)], preventable ADEs (0.52 [0.25–1.09]), potential ADEs (0.70 [0.40–1.22]), and medication errors (0.63 [0.40–0.98]). Practice implications. Most studies of medication therapy management focus on the achievement of intended therapeutic and economic outcomes in community-based ambulatory care. This study showed that the risk of ADEs, especially preventable events, and medication errors was reduced substantially by specially trained pharmacists. Drug misadventures, including ADEs and medication errors, add to the overall cost of medication therapy, and medication use can be improved by pharmacy-based programs.