Problems with Inpatient Medications – Medical News

The journal Gaceta Sanitaria publishes a study in which We badyze the problems related to medicines that have been detected in patients admitted to the Hospital del Mar de Barcelona between 2014 and 2015. Thanks to the availability of the computerized medical order and a computer application that allows the monitoring of drug treatment, it is provided the detection and identification of medication problems.

During these two years, there were 4,587 complications among the 44,870 persons admitted to the hospital's medical and surgical services, ie 10.2 cases per 100 admissions. A drug-related problem is considered a situation that, in the process of using the drug, causes or may result in a negative result badociated with the drug.

68% of drug-related problems were detected in patients admitted to services. doctors like cardiology

In this sense, the work that they did in the Catalan hospital detected that the main problem related to the medication are the prescription errors related to the use incorrect computerized medical order 18.1% of cases. They are followed by interactions, occurring in 13.3% of cases, and the need for adjustment for renal and hepatic insufficiency, occurring in 11.5% of cases.

68% of drug-related problems were detected in patients admitted to medical services, with a focus on cardiology and coronary unit, a service that accounted for 15.6% of cases. The increase in the number of drugs in patients admitted to this service, mainly due to the greater complexity of the pathology and badociated comorbidity, could explain these results.

Cardiology is followed by digestion services (9.5%), pneumology (8.1%) and nephrology (5.6%). In contrast, among surgical services, orthopedic surgery and trauma were distinguished with 8.5% of cases

499 different drugs in total caused at least one drug-related problem during the study period, of which 15 were involved in more than 33% of the total cases.

Enoxaparin was one of the drugs that caused the most common problems (in 3.5% of cases), similar to what has been observed in other studies, this drug was the cause of 46.9% of visits to the emergency room because of drug-related adverse events. Atorvastatin (3.6%), amoxicillin-clavulanic acid (3.4%), ipratropium bromide (3.2%) and levothyroxine (3.1%) are of the other drugs that caused the most patients admitted

The most common recommendation was the change in diet (in 43.4% of cases), followed by correction of the prescription error ( 18.2%)

Modification and Prescription Errors

The most common recommendation was diet modification (in 43.4% of cases), followed by correction of the 39, prescription error (18.2%). The degree of acceptance of pharmaceutical interventions made once the drug-related problem was detected was 81%, the introduction or suspension of a drug being two of the interventions that showed an badociation with greater acceptance.

The drug-related problems reported by the Barcelona Hospital del Mar with this study are much lower than those presented in other surveys conducted in different hospitals.

This is because the computerized clinical record has an integrated computer application that allows the pharmacy department team to present the pharmacological characteristics of each drug (dose, frequency and route of administration , dosage in particular situations, interactions and adverse effects) and cross them with data from the patient's computerized clinical history.

the gaps generates a series of alerts that we have seen they are evaluated by a team of clinical pharmacists to perform the corresponding intervention depending on the characteristics of the patient and the drug involved.

Reference bibliographic:

Olivia Ferrández et al. al Analysis of drug problems in a tertiary hospital in Barcelona. Sanitary Gazette 2018. Online preview available on: http://gacetasanitaria.org/es/badisis-los-problemas-relacionados-con/avance/S0213911118300438/