July 11, 2012

Half of Heart Patients Make Medication
Errors Despite Pharmacist Help

Nashville, TNHalf of the heart patients in a recent study made medication errors when they returned home from the hospital, and the involvement of pharmacists in their care didn't make much of a difference, according to a new study published in the Annals of Internal Medicine.

The study, "Pharmacist Intervention for Low Literacy in Cardiovascular Disease," found that those patients assigned to a group with pharmacist intervention, including checks of medication accuracy, in-patient counseling, patient-education materials, and telephone follow-up, didn't fare any better in the 30 days following hospitalization than those who received usual care.

For the Vanderbilt University–led study, researchers randomly assigned 851 adults hospitalized at two tertiary-care academic hospitals for acute coronary syndromes or acute decompensated heart failure to either usual care or usual care plus a pharmacist intervention. They reported that 432 (50.8%) had 1 or more clinically important medication errors; 22.9% of such errors were judged to be serious and 1.8% life-threatening. Adverse drug events (ADEs) occurred in 258 patients (30.3%) and potential ADEs in 253 patients (29.7%).

Pharmacist intervention did not significantly affect clinically important medication errors (unadjusted incidence rate ratio, 0.92 [95% CI, 0.77-1.10]) or ADEs (unadjusted incidence rate ratio, 1.09 [CI, 0.86-1.39]), although patients in the intervention group tended to have fewer potential ADEs (unadjusted incidence rate ratio, 0.80 [CI, 0.61-1.04]).

"Clinically important medication errors were present among one-half of patients after hospital discharge and were not significantly reduced by a health literacy–sensitive, pharmacist-delivered intervention," the authors noted.

The study, which noted that the patients most vulnerable to medication errors are the elderly, those with impaired cognitive function or low health literacy, or patients who are prescribed numerous or high-risk medications, suggested that more research is needed to uncover effective interventions.

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