Identifying older inpatients at high risk of unintentional medication discrepancies: a classification tree analysis.
Drug management
Medication reconciliation
Older adults
Pharmacological care
Unintentional medication discrepancy
Journal
Aging clinical and experimental research
ISSN: 1720-8319
Titre abrégé: Aging Clin Exp Res
Pays: Germany
ID NLM: 101132995
Informations de publication
Date de publication:
09 Nov 2023
09 Nov 2023
Historique:
received:
03
07
2023
accepted:
16
10
2023
medline:
9
11
2023
pubmed:
9
11
2023
entrez:
9
11
2023
Statut:
aheadofprint
Résumé
Unintentional medication discrepancies at admission are differences between the best possible medication history and the prescribed treatment at admission, and are associated with adverse outcomes, particularly in older people. This study aimed to identify the clinical profiles of geriatric inpatients with unintentional medication discrepancies at hospital admission. A classification tree Chi-square Automatic Interaction Detector (CHAID) analysis was conducted to assess those patients' profiles and characteristics that were associated with a higher risk of unintentional medication discrepancies. One-hundred and thirty consecutive older patients admitted to acute care (87 ± 5 years old; 61.8% women) were assessed. The CHAID analysis retrieved 5 clinical profiles of older inpatients with a risk of up to 94.4% for unintentional medication discrepancies. These profiles were determined based on combinations of three characteristics: use of eye drops, frequent falls (≥ 1/year), and admission due to urgent hospitalization. These easily measurable clinical characteristics may be helpful as a supportive measure to improve pharmacological care.
Identifiants
pubmed: 37943406
doi: 10.1007/s40520-023-02598-2
pii: 10.1007/s40520-023-02598-2
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
Références
Moges TA, Akalu TY, Sema FD (2022) Unintended medication discrepancies and associated factors upon patient admission to the internal medicine wards: identified through medication reconciliation. BMC Health Serv Res 22:1251
doi: 10.1186/s12913-022-08628-5
pubmed: 36243696
pmcid: 9571466
Picone DM, Titler MG, Dochterman J et al (2008) Predictors of medication errors among elderly hospitalized patients. Am J Med Qual 23:115–127
doi: 10.1177/1062860607313143
pubmed: 18305099
Tam VC, Knowles SR, Cornish PL et al (2005) Frequency, type and clinical importance of medication history errors at admission to hospital: a systematic review. CMAJ 173:510–515
doi: 10.1503/cmaj.045311
pubmed: 16129874
pmcid: 1188190
Tobiano G, Chaboyer W, Dornan G et al (2021) Older patients’ engagement in hospital medication safety behaviours. Aging Clin Exp Res 33:3353–3361
doi: 10.1007/s40520-021-01866-3
pubmed: 33945114
Ensing HT, Stuijt CCM, Van Den Bemt BJF et al (2015) Identifying the optimal role for pharmacists in care transitions: a systematic review. J Manag Care Spec Pharm 21:614–638
pubmed: 26233535
Liau SJ, Lalic S, Sluggett JK et al (2021) Medication management in frail older people: consensus principles for clinical practice, research, and education. J Am Med Dir Assoc 22:43–49
doi: 10.1016/j.jamda.2020.05.004
pubmed: 32669236
Quélennec B, Beretz L, Paya D et al (2013) Potential clinical impact of medication discrepancies at hospital admission. 24:530–535
Tomlinson J, Cheong V-L, Fylan B et al (2020) Successful care transitions for older people: a systematic review and meta-analysis of the effects of interventions that support medication continuity. Age Ageing 49:558–569
doi: 10.1093/ageing/afaa002
pubmed: 32043116
pmcid: 7331096
Van Den Bemt PMLA, Van Der Schrieck-De Loos EM, Van Der Linden C et al (2013) Effect of medication reconciliation on unintentional medication discrepancies in acute hospital admissions of elderly adults: a multicenter study. J Am Geriatr Soc 61:1262–1268
doi: 10.1111/jgs.12380
pubmed: 23869999
Seppala LJ, van der Velde N, Masud T et al (2019) EuGMS Task and Finish group on fall-risk-increasing drugs (FRIDs): position on knowledge dissemination, management, and future research [Internet]. Eur Geriatr Med 275–283
Onder G, Vetrano DL, Palmer K et al (2022) Italian guidelines on management of persons with multimorbidity and polypharmacy. Aging Clin Exp Res 34:989
doi: 10.1007/s40520-022-02094-z
pubmed: 35249211
pmcid: 9135855
von Elm E, Altman DG, Egger M et al (2007) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 370:1453–1457
doi: 10.1016/S0140-6736(07)61602-X
Chappe M, Corvaisier M, Brangier A et al (2022) Impact of the COVID-19 pandemic on drug-related problems and pharmacist interventions in geriatric acute care units. Ann Pharm Fr 80:669–677
doi: 10.1016/j.pharma.2021.12.006
pubmed: 34968479
Almanasreh E, Moles R, Chen TF (2020) The medication discrepancy taxonomy (MedTax): the development and validation of a classification system for medication discrepancies identified through medication reconciliation. Res Soc Adm Pharm 16:142–148
doi: 10.1016/j.sapharm.2019.04.005
Magidson J (1994) The CHAID approach to segmentation modeling: Chi-squared automatic interaction detection. In: Bagozzi RP (ed) advanced methods of marketing research. Oxford, Blackwell, pp 118–159
Cabilan CJ, Hughes JA, Shannon C (2017) The use of a contextual, modal and psychological classification of medication errors in the emergency department: a retrospective descriptive study. J Clin Nurs 26:4335–4343
doi: 10.1111/jocn.13760
pubmed: 28207996
Masse M, Yelnik C, Labreuche J et al (2021) Risk factors associated with unintentional medication discrepancies at admission in an internal medicine department. Intern Emerg Med 16:2213–2220
doi: 10.1007/s11739-021-02782-0
pubmed: 34148179
Renom-Guiteras A, Thürmann PA, Miralles R et al (2018) Potentially inappropriate medication among people with dementia in eight European countries. Age Ageing 47:68–74
doi: 10.1093/ageing/afx147
pubmed: 28985257