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Drug Record Discrepancies in an Outpatient Electronic Medical Record: Frequency, Type, and Potential Impact on Patient Care at a Hemodialysis Center
Author(s) -
Manley Harold J.,
Drayer Debra K.,
McClaran Marcy,
Bender Walter,
Muther Richard S.
Publication year - 2003
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.23.2.231.32079
Subject(s) - medicine , medical record , drug , dosing , pharmacist , population , outpatient clinic , observational study , emergency medicine , pharmacy , family medicine , pharmacology , environmental health
Background . Patients who require hemodialysis take many drugs. Electronic drug records may be discrepant with what patients are actually taking. Record discrepancies are a potential source of drug‐related problems. We sought to determine the extent to which drug record discrepancies occur in a hemodialysis population. Methods . This was a prospective observational study of patients enrolled in a pharmacist clinic at an outpatient hemodialysis center from August‐December 2001. Patients participated in monthly drug interviews conducted by a pharmacist, during which patient drug use was determined. Data collected consisted of patient demographics, drug type, and number of drugs. Drug record discrepancies were classified and assigned a potential drug‐related problem. Results were compared with the electronic drug record. Patients with documented drug record discrepancies were compared with those patients for whom no discrepancy was identified. Results . Over the 5‐month period, 215 drug interviews were conducted in 63 patients. One hundred thirteen drug record discrepancies were identified in 38 patients (60%). Discrepancies (mean ± SD 1.7 ± 1.3, range 1–7) were identified during 65 drug interviews (30.2%). Electronic drug records were discrepant by one drug record, two drug records, and more than two drug records 60.0%, 26.2%, and 13.8% of the time, respectively. Drug record discrepancies placed patients at risk for adverse drug events and dosing errors in 49.6% and 34.5%, respectively, of 113 discrepancies. Patient age negatively correlated with the number of drug record discrepancies identified (r=−0.27, p=0.04). Conclusions . Drug record discrepancies occur frequently among patients undergoing hemodialysis. Incorporation of a pharmacist into the patient care team may increase the accuracy of the electronic drug record and avert unnecessary drug‐related problems.