Exploratory Evaluation of Medication Classes Most Commonly Involved in Nursing Home Errors

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• 作者：Rishi J. Desai ; MS^a ; Charlotte E. Williams ; MPH^b ; Sandra B. Greene ; DrPH^b ; ^c ; Stephanie Pierson ; MSHI^b ; Anthony J. Caprio ; MD^d ; Richard A. Hansen ; PhD^e ; ^{rah0019@auburn.edu}
• 关键词：Drug classes ; medication errors ; nursing homes ; drug safety ; health care quality
• 刊名：Journal of the American Medical Directors Association
• 出版年：2013
• 出版时间：June, 2013
• 年：2013
• 卷：14
• 期：6
• 页码：403-408
• 全文大小：239 K

文摘

Background

Medication errors may potentially pose significant risk of harmful outcomes in vulnerable nursing home residents. Current literature lacks data regarding the drug classes most frequently involved in errors in this population and their risk relative to underlying drug class utilization rates.

Objectives

This study (1) describes the frequency and error characteristics for the drug classes most commonly involved in medication errors in nursing homes, and (2) examines the correlation between drug class utilization rates and their involvement in medication errors in nursing home residents.

Design

A cross-sectional analysis of individual medication error incidents reported by North Carolina nursing homes to the Medication Error Quality Initiative during fiscal years 2010 to 2011 was conducted.

Participants

All nursing home residents in the state of North Carolina.

Main measures

The 10 drug classes most frequently involved in medication errors were identified. Characteristics and patient impact of these medication errors were further examined as frequencies and proportions within each drug class. Medication error data were combined with data from the 2004 National Nursing Home Survey to capture nationally representative estimates of medication use by drug class in nursing home patients. The correlation between medication utilization and error involvement was assessed.

Results

There were 32,176 individual medication errors reported to Medication Error Quality Initiative in years 2010-2011. The 10 drug classes most commonly involved in medication errors were analgesics (12.27 % ), anxiolytics/sedative/hypnotics (8.39 % ), antidiabetic agents (5.86 % ), anticoagulants (5.04 % ), anticonvulsants (4.05 % ), antidepressants (4.05 % ), laxatives (3.13 % ), ophthalmic preparations (2.77 % ), antipsychotics (2.47 % ), and diuretics (2.34 % ). The correlation between utilization and medication error involvement was not statistically significant (P value for spearman correlation coefficient?= .88), suggesting certain drug classes are more likely to be involved in medication errors in nursing home patients regardless of the extent of their use.

Conclusions

The drug classes frequently and disproportionately involved in errors in nursing homes include anxiolytics/sedatives/hypnotics, antidiabetic agents, anticoagulants, anticonvulsants, and ophthalmic preparations. Better understanding of the causes and prevention strategies to reduce these errors may improve nursing home patient safety.