Sunil Kripalani|Christianne L. Roumie|Anuj K. Dalal|Courtney Cawthon|Alexandra Businger|Svetlana K. Eden|Ayumi Shintani|Kelly Cunningham Sponsler|L. Jeff Harris|Cecelia Theobald|Robert L. Huang|Danielle Scheurer|Susan Hunt|Terry A. Jacobson|Kimberly J. Rask|Viola Vaccarino|Tejal K. Gandhi|David W. Bates|Mark Williams|Jeffrey L. Schnipper
Effect of a Pharmacist Intervention on Clinically Important Medication Errors After Hospital Discharge
Vanderbilt University Medical Center
background clinically important medication errors common hospital discharge include preventable ameliorable adverse drug events ades well medication discrepancies nonadherence high potential future harm potential ades objective determine effect tailored intervention occurrence clinically important medication errors hospital discharge design randomized controlled trial concealed allocation blinded outcome assessors clinicaltrialsgov registration number nct00632021 setting two tertiary care academic hospitals patients adults hospitalized acute coronary syndromes acute decompensated heart failure intervention pharmacistassisted medication reconciliation inpatient pharmacist counseling lowliteracy adherence aids individualized telephone followup discharge measurements primary outcome number clinically important medication errors per patient first 30 days hospital discharge secondary outcomes included preventable ameliorable ades well potential ades results among 851 participants 432 508 1 clinically important medication errors 229 errors judged serious 18 lifethreatening adverse drug events occurred 258 patients 303 potential ades 253 patients 297 intervention significantly alter perpatient number clinically important medication errors unadjusted incidence rate ratio 092 95 ci 077 110 ades unadjusted incidence rate ratio 109 ci 086 139 patients intervention group tended fewer potential ades unadjusted incidence rate ratio 080 ci 061 104 limitation characteristics study hospitals participants may limit generalizability conclusion clinically important medication errors present among one half patients hospital discharge significantly reduced healthliteracysensitive pharmacistdelivered intervention primary funding source national heart lung blood institute