Medication discontinuity errors in the perioperative period
Background: Inappropriate withdrawal or continuation of medication in the perioperative period is associated with an increased risk for adverse events. To reduce this risk, it is important that patients take their regular medication as prescribed. We evaluated this treatment objective by studying th...
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Published in | Acta anaesthesiologica Scandinavica Vol. 54; no. 10; pp. 1185 - 1191 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Oxford, UK
Blackwell Publishing Ltd
01.11.2010
Blackwell |
Subjects | |
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Abstract | Background: Inappropriate withdrawal or continuation of medication in the perioperative period is associated with an increased risk for adverse events. To reduce this risk, it is important that patients take their regular medication as prescribed. We evaluated this treatment objective by studying the frequency and reasons for errors related to medication discontinuity in the perioperative period.
Methods: Patients scheduled for non‐cardiac surgery were included in this cross‐sectional study. Perioperative medication intake was assessed at the holding area of the operation theatre complex and on the ward during the first 24 h after surgery. Medication intake data were obtained from medical records and by questioning patients and compared with pre‐operative instructions.
Results: The study included 701 patients, of whom 485 (69%) used regular medication. Medication was incorrectly taken or discontinued before surgery in 27% of the patients. In 57% of these patients, the reason for incorrect intake was an unclear or a falsely understood instruction before surgery. Post‐operative medication errors occurred in 26% of the patients.
Conclusion: Medication errors occur frequently in the perioperative period, even in the era of an electronic medication file. Errors in prescription, administration and intake of medication are not easily solved because no single health care professional is responsible for adequate intake of medication in surgical patients. The anaesthesiologist should take on a more prominent role in regulating perioperative medication intake in surgical patients. |
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AbstractList | Background: Inappropriate withdrawal or continuation of medication in the perioperative period is associated with an increased risk for adverse events. To reduce this risk, it is important that patients take their regular medication as prescribed. We evaluated this treatment objective by studying the frequency and reasons for errors related to medication discontinuity in the perioperative period.
Methods: Patients scheduled for non‐cardiac surgery were included in this cross‐sectional study. Perioperative medication intake was assessed at the holding area of the operation theatre complex and on the ward during the first 24 h after surgery. Medication intake data were obtained from medical records and by questioning patients and compared with pre‐operative instructions.
Results: The study included 701 patients, of whom 485 (69%) used regular medication. Medication was incorrectly taken or discontinued before surgery in 27% of the patients. In 57% of these patients, the reason for incorrect intake was an unclear or a falsely understood instruction before surgery. Post‐operative medication errors occurred in 26% of the patients.
Conclusion: Medication errors occur frequently in the perioperative period, even in the era of an electronic medication file. Errors in prescription, administration and intake of medication are not easily solved because no single health care professional is responsible for adequate intake of medication in surgical patients. The anaesthesiologist should take on a more prominent role in regulating perioperative medication intake in surgical patients. Inappropriate withdrawal or continuation of medication in the perioperative period is associated with an increased risk for adverse events. To reduce this risk, it is important that patients take their regular medication as prescribed. We evaluated this treatment objective by studying the frequency and reasons for errors related to medication discontinuity in the perioperative period. Patients scheduled for non-cardiac surgery were included in this cross-sectional study. Perioperative medication intake was assessed at the holding area of the operation theatre complex and on the ward during the first 24 h after surgery. Medication intake data were obtained from medical records and by questioning patients and compared with pre-operative instructions. The study included 701 patients, of whom 485 (69%) used regular medication. Medication was incorrectly taken or discontinued before surgery in 27% of the patients. In 57% of these patients, the reason for incorrect intake was an unclear or a falsely understood instruction before surgery. Post-operative medication errors occurred in 26% of the patients. Medication errors occur frequently in the perioperative period, even in the era of an electronic medication file. Errors in prescription, administration and intake of medication are not easily solved because no single health care professional is responsible for adequate intake of medication in surgical patients. The anaesthesiologist should take on a more prominent role in regulating perioperative medication intake in surgical patients. BACKGROUNDInappropriate withdrawal or continuation of medication in the perioperative period is associated with an increased risk for adverse events. To reduce this risk, it is important that patients take their regular medication as prescribed. We evaluated this treatment objective by studying the frequency and reasons for errors related to medication discontinuity in the perioperative period.METHODSPatients scheduled for non-cardiac surgery were included in this cross-sectional study. Perioperative medication intake was assessed at the holding area of the operation theatre complex and on the ward during the first 24 h after surgery. Medication intake data were obtained from medical records and by questioning patients and compared with pre-operative instructions.RESULTSThe study included 701 patients, of whom 485 (69%) used regular medication. Medication was incorrectly taken or discontinued before surgery in 27% of the patients. In 57% of these patients, the reason for incorrect intake was an unclear or a falsely understood instruction before surgery. Post-operative medication errors occurred in 26% of the patients.CONCLUSIONMedication errors occur frequently in the perioperative period, even in the era of an electronic medication file. Errors in prescription, administration and intake of medication are not easily solved because no single health care professional is responsible for adequate intake of medication in surgical patients. The anaesthesiologist should take on a more prominent role in regulating perioperative medication intake in surgical patients. Background: Inappropriate withdrawal or continuation of medication in the perioperative period is associated with an increased risk for adverse events. To reduce this risk, it is important that patients take their regular medication as prescribed. We evaluated this treatment objective by studying the frequency and reasons for errors related to medication discontinuity in the perioperative period. Methods: Patients scheduled for non‐cardiac surgery were included in this cross‐sectional study. Perioperative medication intake was assessed at the holding area of the operation theatre complex and on the ward during the first 24 h after surgery. Medication intake data were obtained from medical records and by questioning patients and compared with pre‐operative instructions. Results: The study included 701 patients, of whom 485 (69%) used regular medication. Medication was incorrectly taken or discontinued before surgery in 27% of the patients. In 57% of these patients, the reason for incorrect intake was an unclear or a falsely understood instruction before surgery. Post‐operative medication errors occurred in 26% of the patients. Conclusion: Medication errors occur frequently in the perioperative period, even in the era of an electronic medication file. Errors in prescription, administration and intake of medication are not easily solved because no single health care professional is responsible for adequate intake of medication in surgical patients. The anaesthesiologist should take on a more prominent role in regulating perioperative medication intake in surgical patients. |
Author | VAN KLEI, W. A. VAN WAES, J. A. R. EGBERTS, A. C. G. DE GRAAFF, J. C. |
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Cites_doi | 10.1136/bmj.296.6624.744 10.1046/j.1365-2125.2000.00145.x 10.1111/j.1365-2044.1987.tb03045.x 10.1001/archinte.167.10.1034 10.1046/j.1365-2346.1999.00542.x 10.2165/00002018-200225070-00003 |
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References_xml | – volume: 296 start-page: 744 year: 1988 article-title: Do patients fasting before and after operation receive their prescribed drug treatment? publication-title: Br Med J – volume: 59 start-page: 971 year: 2004 end-page: 8 article-title: The accuracy of trained nurses in preoperative health assessment publication-title: results of the OPEN study – volume: 30 start-page: 510 year: 2005 end-page: 5 article-title: Frequency, type and clinical importance of medication history errors at admission to hospital publication-title: a systematic review – volume: 49 start-page: 353 year: 2000 end-page: 62 article-title: Polypharmacy in a general surgical unit and consequences of drug withdrawal publication-title: Br J Clin Pharmacol – volume: 42 start-page: 305 year: 1987 end-page: 6 article-title: Concurrent drug therapy in patients undergoing surgery publication-title: Anaesthesia – volume: 46 start-page: 456 year: 1991 end-page: 9 article-title: Peri‐operative drug prescribing pattern and manufacturers' guidelines publication-title: an audit – volume: 16 start-page: 565 year: 1999 end-page: 8 article-title: Pre‐operative fasting and administration of regular medications in adult patients presenting for elective surgery. Has the new evidence changed practice? publication-title: Eur J Anaesthesiol – volume: 25 start-page: 489 year: 2002 end-page: 95 article-title: Interrupting drug therapy in the perioperative period publication-title: Drug Saf – volume: 167 start-page: 1034 year: 2007 end-page: 40 article-title: Pharmacist medication assessments in a surgical preadmission clinic publication-title: Arch Intern Med – ident: e_1_2_5_5_2 doi: 10.1136/bmj.296.6624.744 – ident: e_1_2_5_2_2 doi: 10.1046/j.1365-2125.2000.00145.x – ident: e_1_2_5_4_2 doi: 10.1111/j.1365-2044.1987.tb03045.x – ident: e_1_2_5_8_2 doi: 10.1001/archinte.167.10.1034 – volume: 59 start-page: 971 year: 2004 ident: e_1_2_5_9_2 article-title: The accuracy of trained nurses in preoperative health assessment publication-title: results of the OPEN study contributor: fullname: Van Klei WA – volume: 30 start-page: 510 year: 2005 ident: e_1_2_5_10_2 article-title: Frequency, type and clinical importance of medication history errors at admission to hospital publication-title: a systematic review contributor: fullname: Tam VC – volume: 46 start-page: 456 year: 1991 ident: e_1_2_5_6_2 article-title: Peri‐operative drug prescribing pattern and manufacturers' guidelines publication-title: an audit contributor: fullname: Kluger MT – ident: e_1_2_5_7_2 doi: 10.1046/j.1365-2346.1999.00542.x – ident: e_1_2_5_3_2 doi: 10.2165/00002018-200225070-00003 |
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Snippet | Background: Inappropriate withdrawal or continuation of medication in the perioperative period is associated with an increased risk for adverse events. To... Inappropriate withdrawal or continuation of medication in the perioperative period is associated with an increased risk for adverse events. To reduce this... Background: Inappropriate withdrawal or continuation of medication in the perioperative period is associated with an increased risk for adverse events. To... BACKGROUNDInappropriate withdrawal or continuation of medication in the perioperative period is associated with an increased risk for adverse events. To reduce... |
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SubjectTerms | Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cross-Sectional Studies Data Interpretation, Statistical Drug Prescriptions Female Humans Intraoperative Care Male Medical sciences Medication Errors - statistics & numerical data Middle Aged Patient Education as Topic Patients Perioperative Care Perioperative Period - statistics & numerical data Treatment Outcome |
Title | Medication discontinuity errors in the perioperative period |
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