Development and validation of a score to assess risk of medication errors detected during medication reconciliation process at admission in internal medicine unit: SCOREM study. Issue 2 (14th December 2020)

• Record Type: Journal Article
• Authors: Audurier, Yohan; Roubille, Camille; Manna, Federico; Zerkowski, Laetitia; Faucanie, Marie; Macioce, Valérie; Castet‐Nicolas, Audrey; Jalabert, Anne; Villiet, Maxime; Fesler, Pierre; Lohan‐Descamps, Laura; Breuker, Cyril
• Is Part Of: International journal of clinical practice. Volume 75:Issue 2(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-12-14
• Subjects: Clinical medicine -- Periodicals; Medicine -- Periodicals; 610.5
• DOI: 10.1111/ijcp.13663
• Languages: English
• ISSNs: 1368-5031

Abstract

Abstract: Background: Medication errors (ME) can be reduced through preventive strategies such as medication reconciliation. Such strategies are often limited by human resources and need targeting high risk patients. Aims: To develop a score to identify patients at risk of ME detected during medication reconciliation in a specific population from internal medicine unit. Methods: Prospective observational study conducted in an internal medicine unit of a French University Hospital from 2012 to 2016. Adult hospitalised patients were eligible for inclusion. Medication reconciliation was conducted by a pharmacist and consisted in comparing medication history with admission prescription to identify MEs. Risk factors of MEs were analysed using multivariate stepwise logistic regression model. A risk score was constructed using the split‐sample approach. The split was done at random (using a fixed seed) to define a development data set (N = 1256) and a validation sample (N = 628). A regression coefficient‐base scoring system was used adopting the beta‐Sullivan approach (Sullivan's scoring). Results: Pharmacists detected 740 MEs in 368/1884 (19.5%) patients related to medication reconciliation. Female gender, number of treatments >7, admission from emergency department and during night or weekend were significantly associated with a higher risk of MEs. Risk score was constructed by attributing 1 or 2 points to these variables. Patients with a score ≥3 (OR [95% CI] 3.10 [1.15‐8.37]) out of 5 (OR [95% CI] 8.11 [2.89‐22.78]) were considered at high risk of MEs. Conclusions: Risk factors identified in our study may help prioritising patients admitted in internal medicine units who may benefit the most from medication reconciliation (ClinicalTrials.gov number NCT03422484).