Pharmacist intervention before surgery reduces drug errors
Sivanagk/Dreamstime.com
Surgical patients who are assessed by a pharmacist before admission
have fewer postoperative medication discrepancies |
Assessment by a pharmacist in a surgical preadmission clinic can reduce drug errors related to postoperative medicines, according to a new US study (Archives of Internal Medicine 2007;167:1034–40).
A total of 464 patients who had an appointment at a preadmission clinic
before surgery were enrolled in the study. Of these, 227 were randomised
to the intervention group, where a structured drug history was taken
by a pharmacist and the information was used to create a postoperative
medicines order form. This form was used by the surgeon to indicate which
medicines were to be continued after surgery.
The remaining 237 patients received standard care, in which a nurse took
the drug history and entered it onto the patient’s electronic record,
which was used by the surgeon to generate the postoperative medicine
orders.
The researchers found that 86 of the 214 patients eligible for analysis
in the standard care group (40.2 per cent) had at least one postoperative
medication discrepancy related to home medicines, compared with 41 of
202 patients in the intervention group (20.3 per cent). Reasons for the
discrepancies in the intervention group include patients reporting that
they were taking medicines that were not recorded at the preadmisssion
clinic and medicines being prescribed at a later stage.
In the intervention group 26 of 202 patients (12.9 per cent) had a medicine
discrepancy likely to cause harm, compared with 64 of 214 patients (29.9
per cent) in the standard care group (P<0.001). These were most commonly
failures to reorder medicines a patient was taking at home.
The authors say that the intervention used in this study may be beneficial
to patients in other services with high medication discrepancy rates
on admission and discharge.
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Hospital
Pharmacist