Prescribing errors in post - COVID-19 patients: prevalence, severity, and risk factors in patients visiting a post - COVID-19 outpatient clinic.
COVID-19
Clinical pharmacology
Pharmacotherapeutic stewardship
Prescribing errors
Journal
BMC emergency medicine
ISSN: 1471-227X
Titre abrégé: BMC Emerg Med
Pays: England
ID NLM: 100968543
Informations de publication
Date de publication:
05 03 2022
05 03 2022
Historique:
received:
19
10
2021
accepted:
14
02
2022
entrez:
6
3
2022
pubmed:
7
3
2022
medline:
11
3
2022
Statut:
epublish
Résumé
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has challenged healthcare globally. An acute increase in the number of hospitalized patients has necessitated a rigorous reorganization of hospital care, thereby creating circumstances that previously have been identified as facilitating prescribing errors (PEs), e.g. a demanding work environment, a high turnover of doctors, and prescribing beyond expertise. Hospitalized COVID-19 patients may be at risk of PEs, potentially resulting in patient harm. We determined the prevalence, severity, and risk factors for PEs in post-COVID-19 patients, hospitalized during the first wave of COVID-19 in the Netherlands, 3 months after discharge. This prospective observational cohort study recruited patients who visited a post-COVID-19 outpatient clinic of an academic hospital in the Netherlands, 3 months after COVID-19 hospitalization, between June 1 and October 1 2020. All patients with appointments were eligible for inclusion. The prevalence and severity of PEs were assessed in a multidisciplinary consensus meeting. Odds ratios (ORs) were calculated by univariate and multivariate analysis to identify independent risk factors for PEs. Ninety-eight patients were included, of whom 92% had ≥1 PE and 8% experienced medication-related harm requiring an immediate change in medication therapy to prevent detoriation. Overall, 68% of all identified PEs were made during or after the COVID-19 related hospitalization. Multivariate analyses identified ICU admission (OR 6.08, 95% CI 2.16-17.09) and a medical history of COPD / asthma (OR 5.36, 95% CI 1.34-21.5) as independent risk factors for PEs. PEs occurred frequently during the SARS-CoV-2 pandemic. Patients admitted to an ICU during COVID-19 hospitalization or who had a medical history of COPD / asthma were at risk of PEs. These risk factors can be used to identify high-risk patients and to implement targeted interventions. Awareness of prescribing safely is crucial to prevent harm in this new patient population.
Sections du résumé
BACKGROUND
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has challenged healthcare globally. An acute increase in the number of hospitalized patients has necessitated a rigorous reorganization of hospital care, thereby creating circumstances that previously have been identified as facilitating prescribing errors (PEs), e.g. a demanding work environment, a high turnover of doctors, and prescribing beyond expertise. Hospitalized COVID-19 patients may be at risk of PEs, potentially resulting in patient harm. We determined the prevalence, severity, and risk factors for PEs in post-COVID-19 patients, hospitalized during the first wave of COVID-19 in the Netherlands, 3 months after discharge.
METHODS
This prospective observational cohort study recruited patients who visited a post-COVID-19 outpatient clinic of an academic hospital in the Netherlands, 3 months after COVID-19 hospitalization, between June 1 and October 1 2020. All patients with appointments were eligible for inclusion. The prevalence and severity of PEs were assessed in a multidisciplinary consensus meeting. Odds ratios (ORs) were calculated by univariate and multivariate analysis to identify independent risk factors for PEs.
RESULTS
Ninety-eight patients were included, of whom 92% had ≥1 PE and 8% experienced medication-related harm requiring an immediate change in medication therapy to prevent detoriation. Overall, 68% of all identified PEs were made during or after the COVID-19 related hospitalization. Multivariate analyses identified ICU admission (OR 6.08, 95% CI 2.16-17.09) and a medical history of COPD / asthma (OR 5.36, 95% CI 1.34-21.5) as independent risk factors for PEs.
CONCLUSIONS
PEs occurred frequently during the SARS-CoV-2 pandemic. Patients admitted to an ICU during COVID-19 hospitalization or who had a medical history of COPD / asthma were at risk of PEs. These risk factors can be used to identify high-risk patients and to implement targeted interventions. Awareness of prescribing safely is crucial to prevent harm in this new patient population.
Identifiants
pubmed: 35247982
doi: 10.1186/s12873-022-00588-7
pii: 10.1186/s12873-022-00588-7
pmc: PMC8897739
doi:
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
35Informations de copyright
© 2022. The Author(s).
Références
JAMA. 2020 Aug 25;324(8):782-793
pubmed: 32648899
J Hosp Med. 2020 May;15(5):314-315
pubmed: 32379040
J Med Virol. 2020 Sep;92(9):1449-1459
pubmed: 32242947
Eur J Clin Pharmacol. 2014 Jun;70(6):637-45
pubmed: 24671697
Acta Biomed. 2021 May 12;92(2):e2021097
pubmed: 33988143
Int J Infect Dis. 2020 May;94:44-48
pubmed: 32171952
Am J Gastroenterol. 2012 Jul;107(7):1011-9
pubmed: 22525304
Br J Clin Pharmacol. 2015 Oct;80(4):808-17
pubmed: 25677107
N Engl J Med. 2020 Jun 11;382(24):2327-2336
pubmed: 32275812
Clin Microbiol Infect. 2021 Feb;27(2):264-268
pubmed: 33068758
J Clin Endocrinol Metab. 2011 Jan;96(1):53-8
pubmed: 21118827
Am J Gastroenterol. 2007 Sep;102(9):2047-56; quiz 2057
pubmed: 17509031
JAMA. 1995 Jul 5;274(1):29-34
pubmed: 7791255
Qual Health Care. 2000 Dec;9(4):232-7
pubmed: 11101708
J Gen Intern Med. 2008 Sep;23(9):1414-22
pubmed: 18563493
Ann Intern Med. 1966 Oct;65(4):629-40
pubmed: 5926386
CMAJ. 2004 Jul 6;171(1):33-8
pubmed: 15238493
Arch Intern Med. 2012 Jul 23;172(14):1057-69
pubmed: 22733210
JAMA. 2011 Aug 24;306(8):840-7
pubmed: 21862745
Ann Pharmacother. 2008 Oct;42(10):1373-9
pubmed: 18780806
Sci Adv. 2021 Sep 03;7(36):eabj5365
pubmed: 34516917
Br J Clin Pharmacol. 2021 Feb;87(2):565-576
pubmed: 32520431
BMC Med. 2018 Feb 13;16(1):21
pubmed: 29433501
PLoS One. 2019 Mar 12;14(3):e0213593
pubmed: 30861042
Int J Clin Pharm. 2016 Oct;38(5):1172-81
pubmed: 27473712
BMJ Open. 2018 May 5;8(5):e019101
pubmed: 29730617
Bone. 2011 Apr 1;48(4):768-76
pubmed: 21185417
Am J Hosp Pharm. 1991 Dec;48(12):2611-6
pubmed: 1814201
Crit Care Med. 1997 Aug;25(8):1289-97
pubmed: 9267940
J Healthc Qual. 2006 May-Jun;28(3):12-9
pubmed: 17518010
Crit Care Med. 2019 Apr;47(4):543-549
pubmed: 30855330
Br J Clin Pharmacol. 2015 Dec;80(6):1254-68
pubmed: 27006985
Evid Based Nurs. 2020 Apr;23(2):61
pubmed: 31337634
JAMA. 1997 Jan 22-29;277(4):312-7
pubmed: 9002494
Drug Saf. 2020 Jun;43(6):517-537
pubmed: 32125666
Br J Clin Pharmacol. 2012 Oct;74(4):668-75
pubmed: 22554316
BMJ. 2017 Oct 9;359:j4328
pubmed: 28993308
Arch Intern Med. 2010 May 10;170(9):784-90
pubmed: 20458086
Crit Care. 2018 Jan 28;22(1):19
pubmed: 29374498
BMJ. 2006 Sep 2;333(7566):459-60
pubmed: 16946321
Lancet. 2020 Oct 24;396(10259):1345-1352
pubmed: 33031764
Crit Care. 2008;12(2):208
pubmed: 18373883
N Engl J Med. 2020 Nov 5;383(19):1813-1826
pubmed: 32445440
Int J Antimicrob Agents. 2020 Jun;55(6):105948
pubmed: 32201353
Int J Antimicrob Agents. 2020 Jul;56(1):105949
pubmed: 32205204
Am J Gastroenterol. 2011 Jul;106(7):1209-18; quiz 1219
pubmed: 21483462