title: Risk of prescribing errors in acutely admitted patients: a pilot study.
abstract: Background Prescribing errors in emergency settings occur frequently. Knowing which patients have the highest risk of errors could improve patient outcomes. Objective The aim of this study was to test an algorithm designed to assess prescribing error risk in individual patients, and to test the feasibility of medication reviews in high-risk patients. Setting The study was performed at the Acute Admissions Unit at Aarhus University Hospital, Denmark. Methods The study was an interventional pilot study. Patients included were assessed according to risk of prescribing errors with the aid of an algorithm called 'Medication Risk Score' (MERIS). Based on the score, high-risk patients were offered a medication review. The clinical relevance of the medication reviews was assessed retrospectively. Main outcome measure The number and nature of prescribing errors during the patients' hospitalisation. Results The study included 103 patients, all of whom could be risk assessed with the algorithm MERIS. MERIS stratified 38 patients as high-risk patients and 65 as low-risk patients. The 103 patients were prescribed a total of 848 drugs in which 88 prescribing errors were found (10.4 %). Sixty-two of these were found in patients in the high-risk group. In general, the medication reviews were found to be clinically relevant and approximately 50 % of recommendations were implemented. Conclusion MERIS was found to be applicable in a clinical setting and stratified most patients with prescribing errors into the high-risk group. The medication reviews were feasible and found to be clinically relevant by most raters.
authors.affiliation: Hospital Pharmacy, Central Denmark Region, Skovlyvej 1, 8930, Randers NØ, Denmark. dortbonn@rm.dk.
authors.forename: Dorthe Krogsgaard
authors.initials: DK
authors.lastname: Bonnerup
authors.affiliation: Research Centre for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Marianne
authors.initials: M
authors.lastname: Lisby
authors.affiliation: Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Eva Aggerholm
authors.initials: EA
authors.lastname: Sædder
authors.affiliation: Hospital Pharmacy, Central Denmark Region, Skovlyvej 1, 8930, Randers NØ, Denmark.
authors.forename: Charlotte Arp
authors.initials: CA
authors.lastname: Sørensen
authors.affiliation: Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Birgitte
authors.initials: B
authors.lastname: Brock
authors.affiliation: Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Ljubica
authors.initials: L
authors.lastname: Andersen
authors.affiliation: Hospital Pharmacy, Central Denmark Region, Skovlyvej 1, 8930, Randers NØ, Denmark.
authors.forename: Anette Gjetrup
authors.initials: AG
authors.lastname: Eskildsen
authors.affiliation: Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Lars Peter
authors.initials: LP
authors.lastname: Nielsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D011307:Drug Prescriptions / Q000592:standards*; D017723:Drug Utilization Review / Q000592:standards* / Q000639:trends; D005260:Female; D006760:Hospitalization / Q000639:trends; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000517:prevention & control* / Q000639:trends; D008875:Middle Aged; D010343:Patient Admission / Q000592:standards* / Q000639:trends; D010607:Pharmacy Service, Hospital / Q000592:standards* / Q000639:trends; D010865:Pilot Projects; D012307:Risk Factors; D055815:Young Adult
keywords: Acute admissions unit; Denmark; Medication reviews; Medication risk score; Prescribing errors