Abstract
BackgroundMedication discrepancies are seen frequently in hospital setting upon admission or discharge. Medication Reconciliation service is a practice designed to ensure that patients’ medications are ordered in a correct manner upon hospital admission, thus reducing the risk of having medication discrepancies. This study aimed to determine the prevalence of medication discrepancies and their clinical seriousness in pediatric patients at the time of hospital admission.MethodsA prevalence cross-sectional study was conducted at the pediatric departement at the Jordan University hospital between March–May 2018. During the study period, 100 pediatric patients were enrolled using a convenience sampling method. Patients’ medical records were reviewed by two clinical pharmacist-reserachers to obtain patients' demographic, medical, and admission medication information. All parents were interviewed to obtain information regarding their children’s Best Possible Medication History (BPMH). Following data collection, differences between patient’s current admission medications and the BPMH were identified as medication discrepancies, and then they were classified into either undocumented intentional or unintentional discrepancies.ResultsAmong the 100 medication records reviewed, 13.0% (13 out of 100) contained at least one unintentional discrepancy, with the majority (n = 11, 84.6%) being classified to be associated with mild potential harm to patients. Of those discrepancies, 8 were omission of medications (61.5%) and 5 were addition of unnecessary medication (38.5%). On the other hand, 35.0% (35 out of 100) of medication records contained at least one intentional undocumented discrepancy.ConclusionsThis study revealed that unintentional medication discrepancies exist at the time of hospital admission for pediatric patients but with low proportion. The low proportion of medication discrepancies might be explained by the recent implementation of medication reconciliation service at the studied hospital. Also, intentional undocumented discrepancies were common, which may carry a potential harm to such vulnerable population at discharge. These data may inform the need for a strict policies to regulate medication documentation, thus decreasing the possibilities of medication errors.
Highlights
Medication discrepancies are seen frequently in hospital setting upon admission or discharge
Demographic and medical characteristics of the study participants and their parents During the study period, 230 pediatric patients were screened for eligibility criteria
Among the 100 medication records reviewed, a total of 411 medications were identified, with a mean of 4.1 (SD ± 2.6) admission medications per patient prescribed upon hospital admission
Summary
Medication discrepancies are seen frequently in hospital setting upon admission or discharge. This study aimed to determine the prevalence of medication discrepancies and their clinical seriousness in pediatric patients at the time of hospital admission. Obtaining incomplete medication history is attributed to a quarter of hospital prescribing errors [1,2,3]. In heathcare setting, these errors are associated with increasing the incidence of adverse effect affecting patients’ quality of life [4]. Almost 60% of medication errors occur at admission, transfer, or discharge from the hospital as reported by Rozich and Roger [5]. The unique vulnerability of pediatric population is a consequence of several aspects, including the need of weight-based dosing, the need to perform an extemporaneous dispensing or compounding of medications, the need to dilute medications from stock solutions, the lack of mature kidney or liver that might affect medications’ metabolism or elimination, the dependent of such population on their caregiver to administer their medication and their inability to report any experienced adverse effects [9]
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