Background The process of reconciling medicines not available in the hospital has been demonstrated to be a powerful strategy to prevent adverse drug events.
Purpose To evaluate drug prescription and administration errors after medicines reconciliation (MR) involving medicines not available in the hospital (MNAH) prescribed prior to admission.
Materials and methods We conducted a cross-sectional, observational study in an academic medical centre using computerised physician-order entry (CPOE). After MR at admission, when clinicians decided that these medicines needed to be continued during hospitalisation, since they were not included in the CPOE database, they were prescribed as a generic product, ‘MNAH’ with the drug name and dosage. The main outcome measured was medicines errors involving MNAH detected in the prescription and administration phases.
Results We analysed 338 MNAH prescribed to 207 inpatients, mainly for chronic cardiovascular diseases. We detected 211 prescription errors (62.4%, 95% CI: 57–67.6) most of them related to route of administration and dose and 47 drug administration errors (13.9%, 95% CI: 10.4–18). Omission was the principal type of error in both cases. The main causes of these errors were CPOE program deficiencies (62.1%, 95% CI: 55.1–68.6) and lack of information about medicines history in medical records (31.3%, 95% CI: 25.1–38). Most errors did not reach the patient or reached the patient without causing any harm. Errors that caused harm to patients were due to drug duplication. Clinicians considered that 65.9% (95% CI: 59–72.2) of errors could have been avoided with an improved CPOE system.
Conclusions Errors associated with prescription and administration of MNAH after MR are common among adult inpatients. Our results suggest that there are two main weak points: i) lack of coordination and available information for clinicians about patients’ medicines history, ii) CPOE deficiencies related to MNAH prescription.
No conflict of interest.
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