Emergency department medication lists are not accurate.
BACKGROUND
Medication errors are a common source of adverse events. Errors in the home medication list may impact care in the Emergency Department (ED), the hospital, and the home. Medication reconciliation, a Joint Commission requirement, begins with an accurate home medication list.


OBJECTIVE
To evaluate the accuracy of the ED home medication list.


METHODS
Prospective, observational study of patients aged > 64 years admitted to the hospital. After obtaining informed consent, a home medication list was compiled by research staff after consultation with the patient, their family and, when appropriate, their pharmacy and primary care doctor. This home medication list was not available to ED staff and was not placed in the ED chart. ED records were then reviewed by a physician, blinded to the research-generated home medication list, using a standardized data sheet to record the ED list of medications. The research-generated home medication list was compared to the standard medication list and the number of omissions, duplications, and dosing errors was determined.


RESULTS
There were 98 patients enrolled in the study; 56% (55/98, 95% confidence interval [CI] 46-66%) of the medication lists for these patients had an omission and 80% (78/98, 95% CI 70-87%) had a dosing or frequency error; 87% of ED medication lists had at least one error (85/98, 95% CI 78-93%).


CONCLUSIONS
Our findings now add the ED to the list of other areas within health care with inaccurate medication lists. Strategies are needed that support ED providers in obtaining and communicating accurate and complete medication histories.
Caglar
Selin
S
Department of Emergency Medicine, Baystate Medical Center, Springfield, Massachusetts 01199, USA.
Henneman
Philip L
PL
Blank
Fidela S
FS
Smithline
Howard A
HA
Henneman
Elizabeth A
EA
D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008508:Medication Errors / Q000517:prevention & control*; D059065:Medication Reconciliation; D010343:Patient Admission; D011446:Prospective Studies; D016037:Single-Blind Method