title: Detection of Patients at High Risk of Medication Errors: Development and Validation of an Algorithm.
abstract: Medication errors (MEs) are preventable and can result in patient harm and increased expenses in the healthcare system in terms of hospitalization, prolonged hospitalizations and even death. We aimed to develop a screening tool to detect acutely admitted patients at low or high risk of MEs comprised by items found by literature search and the use of theoretical weighting. Predictive variables used for the development of the risk score were found by the literature search. Three retrospective patient populations and one prospective pilot population were used for modelling. The final risk score was evaluated for precision by the use of sensitivity, specificity and area under the ROC (receiver operating characteristic) curves. The variables used in the final risk score were reduced renal function, the total number of drugs and the risk of individual drugs to cause harm and drug-drug interactions. We found a risk score in the prospective population with an area under the ROC curve of 0.76. The final risk score was found to be quite robust as it showed an area under the ROC curve of 0.87 in a recent patient population, 0.74 in a population of internal medicine and 0.66 in an orthopaedic population. We developed a simple and robust score, MERIS, with the ability to detect patients and divide them according to low and high risk of MEs in a general population admitted at acute admissions unit. The accuracy of the risk score was at least as good as other models reported using multiple regression analysis.
authors: Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark.
authors: Eva Aggerholm
authors: EA
authors: Saedder
authors: Research Center of Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors: Marianne
authors: M
authors: Lisby
authors: Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark.
authors: Lars Peter
authors: LP
authors: Nielsen
authors: Department of Endocrinology, Gentofte University Hospital, Copenhagen, Denmark.
authors: Jørgen
authors: J
authors: Rungby
authors: Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark.
authors: Ljubica Vukelic
authors: LV
authors: Andersen
authors: Hospital Pharmacy, Aarhus, Denmark.
authors: Dorthe Krogsgaard
authors: DK
authors: Bonnerup
authors: Department of Biochemistry, Department of Biomedicine, Aarhus University Hospital, Aarhus, Denmark.
authors: Birgitte
authors: B
authors: Brock
mesh_terms: D000465:Algorithms; D004358:Drug Therapy / Q000379:methods / Q000592:standards; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007388:Internal Medicine / Q000379:methods* / Q000592:standards; D008508:Medication Errors / Q000517:prevention & control / Q000706:statistics & numerical data; D009985:Orthopedics / Q000379:methods* / Q000592:standards; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D012372:ROC Curve; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D004364:Pharmaceutical Preparations