Medication, allergy, and adverse drug event discrepancies in ambulatory care.
OBJECTIVE
A first step in reducing medication errors is for health care workers to be aware of a patient's medications, allergies, and any previously documented adverse drug events (ADEs). This study sought to determine the frequency of medication and allergy/ADE-related discrepancies in a family medicine residency clinic.


METHODS
Patients were contacted prior to appointments and asked to bring in prescription and over-the-counter medications. A research assistant interviewed 157 patients and recorded each drug a patient was taking, together with dosage, dosing frequency, known allergies, and demographic information. This information was then compared to similar information in the medical record.


RESULTS
Overall, 97% of patients had at least one discrepancy between medications listed in the medical record and medications they were taking, and 32% had an allergy/ADE discrepancy. Discrepancies were highest for women, those with cardiovascular disease, and those hospitalized within the last year. Only the total number of medications was predictive of a discrepancy, however, accounting for 25% of the variability.


CONCLUSIONS
A higher medication discrepancy rate existed in this family medicine residency clinic than the 26%--76% rate that is documented in the literature. The results point to a need for better medication, allergy, and ADE awareness.
Stephens
Mary
M
East Tennessee State University Family Physicians of Kingsport, USA. mary_maniscalco@hotmail.com
Fox
Beth
B
Kukulka
Gary
G
Bellamy
Judith
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000458:organization & administration*; D003266:Continuity of Patient Care / Q000458:organization & administration; D004342:Drug Hypersensitivity; D004363:Drug Utilization; D064420:Drug-Related Side Effects and Adverse Reactions; D005194:Family Practice / Q000458:organization & administration; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008508:Medication Errors; D008875:Middle Aged; D012959:Socioeconomic Factors