SCORE of Medication Error in Internal Medecin Unit

Study Overview
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Brief Summary
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Transfers between interfaces of care are recognized as a source of medication discrepancies, medication errors (MEs) and potentially adverse drug events. ME are very common at hospital and may have important clinical and economic consequences. The lack and loss of medication information and communication between health professionals at points of care transition may often lead to ME. According to the literature, up to two thirds of medication histories contain at least one error. Some studies have compared pharmaceutical team with physician or nurse on the detection of UMD or ME and have reported that pharmacists were one of the best health care providers to establish medication history. To improve medication safety and decrease MEs rate, several institutions have recommended to develop medication reconciliation at all transition points such as admission, transfer and discharge. Medication reconciliation is the process that compares a patient's medication order to all medications that the patient has been taking and should take at admission, transfer and discharge of hospitalization. Medication reconciliation programs led by pharmacists are effective to reduce medications discrepancies. However, studies evaluating the efficacy of medication reconciliation program are very heterogeneous in terms of populations, definitions and methodology. Thus, proportion of ME differs enormously between studies, ranging from under 10% to over 60% at admission of hospitalization. Elderly patients with their numerous comorbidities associated with polypharmacy, such as patients of internal medecin unit, are at high risk of ME and at risk of safety issues. However, medication reconciliation process is very time consuming with an average of 30 minutes by patient. Thereby, review of all inpatients within 24 hours of admissions is very difficult or impossible. Targeting high-risk situation and high-risk patient are crucial to detect ME before causing harm. Therefore, evaluating the risk of MEs and their potential consequences in specific population of internal medicine unit using a validated medication reconciliation process seems of utmost importance for internal medicine specialist clinical practice and the decrease of ME rate. Consequently, the aim of our study was to (i) evaluate the prevalence of ME in an internal medicine unit at admission of hospitalization, (ii) determine the type of medication involved and the potential clinical impact of ME and (iii) identify factors associated with a risk of ME and serious ME.

Official Title
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Developpemment of a Score to Assess Risk of Medication Errors in Internal Medecin Unit

Conditions
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Patient Hospitalized in Internal Medicine Unit

Intervention / Treatment
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* Other: Detection and correction of medication error at hospital admission


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: - Patients aged above 18 years old, admitted to the department during the study period and hospitalized for at least 24 hours Exclusion criteria: - NA

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| People with at least one medication error<br>People with at least one medication error at hospital admission | Other: Detection and correction of medication error at hospital admission<br>* Detection and correction of medication error at hospital admission<br>|
| People without medication error at hospital admission<br>People without medication error at hospital admission | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| number of medication error | number of medication error at hospital admission detected by clinical pharmacist during medication reconciliation process | 1 day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| number of variable associated to the risk of ME | number of variable associated to the risk of ME detected by logistic regression analysis | 1 day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Internal medecine unit, Medication Error, Clinical Pharmacist, Medication reconciliation