Detectability of Medication Errors With a STOPP/START-Based Medication Review in Older People Prior to a Potentially Preventable Drug-Related Hospital Admission

Bastiaan T. G. M. Sallevelt (), Toine C. G. Egberts, Corlina J. A. Huibers, Jimmy Ietswaart, A. Clara Drenth- van Maanen, Emma Jennings, Cian O’Mahony, Katharina Tabea Jungo, Martin Feller, Nicolas Rodondi, François-Xavier Sibille, Anne Spinewine, Eugène P. Puijenbroek, Ingeborg Wilting and Wilma Knol
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Bastiaan T. G. M. Sallevelt: Utrecht University
Toine C. G. Egberts: Utrecht University
Corlina J. A. Huibers: Utrecht University
Jimmy Ietswaart: Utrecht University
A. Clara Drenth- van Maanen: Utrecht University
Emma Jennings: University College Cork
Cian O’Mahony: University College Cork
Katharina Tabea Jungo: University of Bern
Martin Feller: University of Bern
Nicolas Rodondi: University of Bern
François-Xavier Sibille: Université catholique de Louvain
Anne Spinewine: Université catholique de Louvain
Eugène P. Puijenbroek: The Netherlands Pharmacovigilance Centre Lareb
Ingeborg Wilting: Utrecht University
Wilma Knol: Utrecht University

Drug Safety, 2022, vol. 45, issue 12, No 6, 1516 pages

Abstract: Abstract Introduction Multimorbidity and polypharmacy are risk factors for drug-related hospital admissions (DRAs) in the ageing population. DRAs caused by medication errors (MEs) are considered potentially preventable. The STOPP/START criteria were developed to detect potential MEs in older people. Objective The aim of this study was to assess the detectability of MEs with a STOPP/START-based in-hospital medication review in older people with polypharmacy and multimorbidity prior to a potentially preventable DRA. Methods Hospitalised older patients (n = 963) with polypharmacy and multimorbidity from the intervention arm of the OPERAM trial received a STOPP/START-based in-hospital medication review by a pharmacotherapy team. Readmissions within 1 year after the in-hospital medication review were adjudicated for drug-relatedness. A retrospective assessment was performed to determine whether MEs identified at the first DRA were detectable during the in-hospital medication review. Results In total, 84 of 963 OPERAM intervention patients (8.7%) were readmitted with a potentially preventable DRA, of which 72 patients (n = 77 MEs) were eligible for analysis. About half (48%, n = 37/77) of the MEs were not present during the in-hospital medication review and therefore were not detectable at that time. The pharmacotherapy team recommended a change in medication regimen in 50% (n = 20/40) of present MEs, which corresponds to 26% (n = 20/77) of the total identified MEs at readmission. However, these recommendations were not implemented. Conclusion MEs identified at readmission were not addressed by a prior single in-hospital medication review because either these MEs occurred after the medication review (~50%), or no recommendation was given during the medication review (~25%), or the recommendation was not implemented (~25%). Future research should focus on optimisation of the timing and frequency of medication review and the implementation of proposed medication recommendations. Registration ClinicalTrials.gov identifier: NCT02986425. December 8, 2016. Funding European Union HORIZON 2020, Swiss State Secretariat for Education, Research and Innovation (SERI), Swiss National Science Foundation (SNSF) Graphical abstract

Date: 2022
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DOI: 10.1007/s40264-022-01237-5

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