Table 2.
Description of unintentional medication discrepancies (UMDs)
| Stage of service implementation | Total frequency | ||
|---|---|---|---|
| Pre-stage | Post-stage | ||
| Patient affected by UMDs | 23 (13.6%) | 29 (11.9%) | 52 (12.7%) |
| Gender | |||
| Male | 11 (6.5%) | 11 (4.5%) | 22 (5.3%) |
| Female | 12 (7.1%) | 18 (7.4%) | 30 (7.2%) |
| Age, years | |||
| > 65 | 5 (2.9%) | 7 (2.8%) | 12 (2.9%) |
| ≤ 65 | 18 (10.7%) | 21(8.6%) | 39 (9.4%) |
| Total number of included patients in the stage | 168 (100%) | 243 (100%) | 411 (100%) |
| Nature of the UMD | |||
| Medication affected by UMDs | 41 | 48 | 89 |
| Medication discrepancy severity (NCC MERP criteria) | |||
| A: Circumstances or events that have the capacity to cause error | 26 (63.4%) | 30 (62.5%) | 56 (63%) |
| B: An error occurred but the error did not reach the patient | 6 (14.6%) | 7 (14.5%) | 13 (14.6%) |
| C: An error occurred that reached the patient but did not cause patient harm | 2 (4.8%) | 9 (18.7%) | 11 (12.3%) |
| D: An error occurred that reached the patient and required monitoring to confirm that it resulted in no harm to the patient and/or required intervention to preclude harm | 6 (14.6%) | 1 (2%) | 7 (7.8%) |
| E: An error occurred that may have contributed to or resulted in temporary harm to the patient and required intervention | 1 (2.4%) | 0 | 1 (1.1%) |
| Missing data | 0 | 1 (2%) | 1 (1.1%) |
| Medication discrepancy harma | |||
| Potential harm | 37 (90.2%) | 45 (94%) | 82 (92.1%) |
| No harm | 3 (7.3%) | 1 (2%) | 4 (4.4%) |
| Actual harm | 1 (2.4%) | 0 | 1 (1.1%) |
| Missing data | 0 | 2 (4%) | 2 (2.2%) |
| Total medications affected by UMDs | 41 (100%) | 48 (100%) | 89 (100%) |
| Medication class based on British National Formulary chapters | |||
| Cardiovascular system | 20 | 19 | 39 (43.8%) |
| Angiotensin-converting enzyme (ACE) inhibitors | 4 | 6 | |
| Diuretics | 5 | 3 | |
| Central nervous system | 6 | 9 | 15 (16.8%) |
| Opioids | 4 | 1 | |
| Gastrointestinal system | 4 | 5 | 9 (10.1%) |
| Laxatives | 3 | 4 | |
| Endocrine system | 2 | 3 | 5 (5.6%) |
| Respiratory system | 2 | 3 | 5 (5.6%) |
| Blood and blood-forming organs | 1 | 3 | 4 (4.4%) |
| Musculoskeletal system | 1 | 2 | 3 (3.3%) |
| Skin | 1 | 2 | 3 (3.3%) |
| Genito-urinary system | 1 | 1 | 2 (2.2%) |
| Nutrition and metabolic disorders | 1 | 1 | 2 (2.2%) |
| Anti-infective system | 1 | 0 | 1 (1.1%) |
| Eye | 0 | 1 | 1 (1.1%) |
NCC MERP National Coordinating Council for Medication Error Reporting and Prevention, UMDs unintentional medication discrepancies
aCategorised based on the NCC MERP