Development and validation of a score to assess risk of medication errors detected during medication reconciliation process at admission in internal medicine unit: SCOREM study

Yohan Audurier, Camille Roubille, Federico Manna, Laetitia Zerkowski, Marie Faucanie, Valérie Macioce, Audrey Castet-Nicolas, Anne Jalabert, Maxime Villiet, Pierre Fesler, Laura Lohan-Descamps, Cyril Breuker, Yohan Audurier, Camille Roubille, Federico Manna, Laetitia Zerkowski, Marie Faucanie, Valérie Macioce, Audrey Castet-Nicolas, Anne Jalabert, Maxime Villiet, Pierre Fesler, Laura Lohan-Descamps, Cyril Breuker

Abstract

Background: Medication errors (ME) can be reduced through preventive strategies such as medication reconciliation. Such strategies are often limited by human resources and need targeting high risk patients.

Aims: To develop a score to identify patients at risk of ME detected during medication reconciliation in a specific population from internal medicine unit.

Methods: Prospective observational study conducted in an internal medicine unit of a French University Hospital from 2012 to 2016. Adult hospitalised patients were eligible for inclusion. Medication reconciliation was conducted by a pharmacist and consisted in comparing medication history with admission prescription to identify MEs. Risk factors of MEs were analysed using multivariate stepwise logistic regression model. A risk score was constructed using the split-sample approach. The split was done at random (using a fixed seed) to define a development data set (N = 1256) and a validation sample (N = 628). A regression coefficient-base scoring system was used adopting the beta-Sullivan approach (Sullivan's scoring).

Results: Pharmacists detected 740 MEs in 368/1884 (19.5%) patients related to medication reconciliation. Female gender, number of treatments >7, admission from emergency department and during night or weekend were significantly associated with a higher risk of MEs. Risk score was constructed by attributing 1 or 2 points to these variables. Patients with a score ≥3 (OR [95% CI] 3.10 [1.15-8.37]) out of 5 (OR [95% CI] 8.11 [2.89-22.78]) were considered at high risk of MEs.

Conclusions: Risk factors identified in our study may help prioritising patients admitted in internal medicine units who may benefit the most from medication reconciliation (ClinicalTrials.gov number NCT03422484).

© 2020 John Wiley & Sons Ltd.

References

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Source: PubMed

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