Risk factors for medication errors at admission in pre-operatively screened patients. Risicofactoren voor medicatiefouten na eerdere medicatieverificatie bij electieve opnames

BACKGROUND Preoperative screening (POS) may help to reduce medication errors at admission (MEA). However, due to the time window between POS and hospital admission, unintentional medication discrepancies may still occur and thus a second medication reconciliation at hospital admission is necessary. Insight into potential risk factors associated with these discrepancies would be helpful to focus the second medication reconciliation on high risk patients. OBJECTIVE To determine the occurrence of MEA and to identify risk factors for MEA in preoperative screened patients. METHODS This single-centre observational cross-sectional study included elective surgical patients between 26 October and 18 December 2015. Main inclusion criteria were age years and elective non-day care admissions. Medication reconciliation took place at the preoperative screening and was repeated within 30 hours of admission. Unintended discrepancies between the first and second medication reconciliation were defined as MEA. The primary outcome was the occurrence of MEA in preoperative^ screened patients. The association of this outcome with potential risk factors was analysed using multivariate logistic regression analysis. RESULTS Of the 183 included patients 60 (33%) patients had at least one MEA. In a multivariate model the number of medications at POS (adjusted odds ratio 1.16, 95%-confidence interval (95%-CI] 1.04-1.30), and respiratory disease (odds ratio 4.25. 95%-C11.52-11.83) were significantly associated with MEA. CONCLUSION In our study MEA occurred in 33% of preoperative screened patients. Polypharmacy and respiratory comorbidities are risk factors for MEA in preoperative screened patients.