Los Angeles—How effective are electronic pharmacy claims data in preventing medication-history errors and subsequent inpatient order errors?

That was the question Cedars-Sinai medical and pharmacy researchers and colleagues sought to answer in a study recently published in the Journal of the American Informatics Association.

For the investigation, researchers used admission medication history (AMH) data from a recent clinical trial that identified 1,017 AMH errors and 419 resultant inpatient order errors in 194 hospital admissions. The patients were predominantly older adults on complex medication regimens.

Using a subset of patients with current Surescripts electronic pharmacy claims data (SEPCD), two pharmacists independently assessed error severity and the main outcome—whether SEPCD was unrelated to the medication error; probably would not have prevented the error; might have prevented the error; or probably would have prevented the error.

With 70 patients having both AMH errors and current, accessible SEPCD, results indicate that the electronic system probably would have prevented 110 (35%) of 315 AMH errors and 46 (31%) of 147 resultant inpatient order errors.

When the least severe medication errors were excluded, analysis indicates that SEPCD probably would have prevented 99 (47%) of 209 AMH errors and 37 (61%) of 61 resultant inpatient order errors. At the same time, study authors note, SEPCD probably would have prevented at least one AMH error in 42 (60%) of 70 patients.

“When current SEPCD was available for older adult patients on complex medication regimens, it had substantial potential to prevent AMH errors and resultant inpatient order errors, with greater potential to prevent more severe errors,” the report concludes.

Researchers call for further study to measure the benefit of SEPCD in actual use at hospital admissions.

A 2012 study found that the most common medication error at admission was an omitted drug, followed by a wrong dosage.

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