tetano
Editor, Senior Moderator
BMC Emerg Med
. 2022 Mar 5;22(1):35.
doi: 10.1186/s12873-022-00588-7.
Prescribing errors in post - COVID-19 patients: prevalence, severity, and risk factors in patients visiting a post - COVID-19 outpatient clinic
Rashudy F Mahomedradja[SUP] #[/SUP][SUP] 1 2 [/SUP], Tessa O van den Beukel[SUP] #[/SUP][SUP] 3 4 [/SUP], Maaike van den Bos[SUP] 3 [/SUP], Steven Wang[SUP] 3 5 [/SUP], Kirsten A Kalverda[SUP] 6 [/SUP], Birgit I Lissenberg-Witte[SUP] 7 [/SUP], Marianne A Kuijvenhoven[SUP] 8 [/SUP], Esther J Nossent[SUP] 6 [/SUP], Majon Muller[SUP] 4 [/SUP], Kim C E Sigaloff[SUP] 3 9 [/SUP], Jelle Tichelaar[SUP] 3 5 [/SUP], Michiel A van Agtmael[SUP] 3 5 [/SUP]
Affiliations
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has challenged healthcare globally. An acute increase in the number of hospitalized patients has necessitated a rigorous reorganization of hospital care, thereby creating circumstances that previously have been identified as facilitating prescribing errors (PEs), e.g. a demanding work environment, a high turnover of doctors, and prescribing beyond expertise. Hospitalized COVID-19 patients may be at risk of PEs, potentially resulting in patient harm. We determined the prevalence, severity, and risk factors for PEs in post-COVID-19 patients, hospitalized during the first wave of COVID-19 in the Netherlands, 3 months after discharge.
Methods: This prospective observational cohort study recruited patients who visited a post-COVID-19 outpatient clinic of an academic hospital in the Netherlands, 3 months after COVID-19 hospitalization, between June 1 and October 1 2020. All patients with appointments were eligible for inclusion. The prevalence and severity of PEs were assessed in a multidisciplinary consensus meeting. Odds ratios (ORs) were calculated by univariate and multivariate analysis to identify independent risk factors for PEs.
Results: Ninety-eight patients were included, of whom 92% had ≥1 PE and 8% experienced medication-related harm requiring an immediate change in medication therapy to prevent detoriation. Overall, 68% of all identified PEs were made during or after the COVID-19 related hospitalization. Multivariate analyses identified ICU admission (OR 6.08, 95% CI 2.16-17.09) and a medical history of COPD / asthma (OR 5.36, 95% CI 1.34-21.5) as independent risk factors for PEs.
Conclusions: PEs occurred frequently during the SARS-CoV-2 pandemic. Patients admitted to an ICU during COVID-19 hospitalization or who had a medical history of COPD / asthma were at risk of PEs. These risk factors can be used to identify high-risk patients and to implement targeted interventions. Awareness of prescribing safely is crucial to prevent harm in this new patient population.
Keywords: COVID-19; Clinical pharmacology; Pharmacotherapeutic stewardship; Prescribing errors.
. 2022 Mar 5;22(1):35.
doi: 10.1186/s12873-022-00588-7.
Prescribing errors in post - COVID-19 patients: prevalence, severity, and risk factors in patients visiting a post - COVID-19 outpatient clinic
Rashudy F Mahomedradja[SUP] #[/SUP][SUP] 1 2 [/SUP], Tessa O van den Beukel[SUP] #[/SUP][SUP] 3 4 [/SUP], Maaike van den Bos[SUP] 3 [/SUP], Steven Wang[SUP] 3 5 [/SUP], Kirsten A Kalverda[SUP] 6 [/SUP], Birgit I Lissenberg-Witte[SUP] 7 [/SUP], Marianne A Kuijvenhoven[SUP] 8 [/SUP], Esther J Nossent[SUP] 6 [/SUP], Majon Muller[SUP] 4 [/SUP], Kim C E Sigaloff[SUP] 3 9 [/SUP], Jelle Tichelaar[SUP] 3 5 [/SUP], Michiel A van Agtmael[SUP] 3 5 [/SUP]
Affiliations
- PMID: 35247982
- DOI: 10.1186/s12873-022-00588-7
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has challenged healthcare globally. An acute increase in the number of hospitalized patients has necessitated a rigorous reorganization of hospital care, thereby creating circumstances that previously have been identified as facilitating prescribing errors (PEs), e.g. a demanding work environment, a high turnover of doctors, and prescribing beyond expertise. Hospitalized COVID-19 patients may be at risk of PEs, potentially resulting in patient harm. We determined the prevalence, severity, and risk factors for PEs in post-COVID-19 patients, hospitalized during the first wave of COVID-19 in the Netherlands, 3 months after discharge.
Methods: This prospective observational cohort study recruited patients who visited a post-COVID-19 outpatient clinic of an academic hospital in the Netherlands, 3 months after COVID-19 hospitalization, between June 1 and October 1 2020. All patients with appointments were eligible for inclusion. The prevalence and severity of PEs were assessed in a multidisciplinary consensus meeting. Odds ratios (ORs) were calculated by univariate and multivariate analysis to identify independent risk factors for PEs.
Results: Ninety-eight patients were included, of whom 92% had ≥1 PE and 8% experienced medication-related harm requiring an immediate change in medication therapy to prevent detoriation. Overall, 68% of all identified PEs were made during or after the COVID-19 related hospitalization. Multivariate analyses identified ICU admission (OR 6.08, 95% CI 2.16-17.09) and a medical history of COPD / asthma (OR 5.36, 95% CI 1.34-21.5) as independent risk factors for PEs.
Conclusions: PEs occurred frequently during the SARS-CoV-2 pandemic. Patients admitted to an ICU during COVID-19 hospitalization or who had a medical history of COPD / asthma were at risk of PEs. These risk factors can be used to identify high-risk patients and to implement targeted interventions. Awareness of prescribing safely is crucial to prevent harm in this new patient population.
Keywords: COVID-19; Clinical pharmacology; Pharmacotherapeutic stewardship; Prescribing errors.