Medication discrepancies in a hospital in Southern Brazil: the importance of medication reconciliation for patient safety

Medication discrepancies are of great concern in hospitals because they pose risks to patients and increase health care costs. The aim of this study was to estimate the prevalence of inconsistent medication prescriptions to adult patients admitted to a hospital in southern Santa Catarina, Brazil. This was a patient safety study on patients recruited between November 2015 and June 2016. The participants were interviewed and had their medical records reviewed. Discrepant medications were considered those that did not match between the list of medicines taken at home and the prescribed drugs for treatment in a hospital setting. Of the 394 patients included, 98.5% took continuous-use medications at home, with an average of 5.5 medications per patient. Discrepancies totaled 80.2%, The independent variables associated with the discrepancies were systemic arterial hypertension, hypercholesterolemia, vascular disease, number of medications taken at home, and poor documentation of the medications in the medical record. Findings from this study allowed us to conclude there was a high rate of prescription medication misuse. Medication reconciliation is crucial in reducing these errors. Pharmacists can help reduce these medication-related errors and the associated risks and complications.

Iatrogenia medicamentosa em idosos hospitalizados no interior do Amazonas / Iatrogenic medication in elderly hospitalized in Amazonas interior / Iatrogenia de drogas en ancianos hospitalizados en el interior de Amazonas

As iatrogenias são ações decorrentes de intervenções médicas, ou de membro/s de uma equipe médica, que resultem em consequências indesejáveis ou prejudiciais à saúde de um indivíduo hospitalizado. O objetivo deste estudo foi identificar iatrogenias medicamentosas que ocorreram com pacientes idosos internados no Hospital Regional da cidade de Coari, estado de Amazonas, Brasil. Os dados foram coletados de 100 prontuários, dos quais se identificou, por meio de um instrumento criado pelos autores, que a omissão de doses foi a iatrogenia mais frequente em 83,0% dos casos, recomendando-se que se busque compreender causas, fatores de risco, consequências, e pensar em estratégias para diminuir ou minimizar essas ocorrências.

Iatrogenies are actions resulting from medical interventions or from their staff, resulting in undesirable or harmful consequences to the health of the hospitalized individual. The objective of this study was to identify the drug iatrogenies that occurred with elderly patients hospitalized at the Regional Hospital of Coari, Amazonas. The data were collected from 100 charts, which identified that through an instrument created by the authors. The absence of the dose was more frequent of iatrogeny with 83,0%.

Las iatrogenias son acciones derivadas de intervenciones médicas o de su equipo, que resulten em consecuencias indeseables o perjudiciales para la salud del individuo hospitalizado. El objetivo de este estúdio fue identificar las iatrogenias medicamentosas que ocurrieron con pacientes ancianos internados em el Hospital Regional de Coari, Amazonas. Los datos fueron recolectados de 100 prontuarios, que identifico que por medio de um instrumento creado por los autores. La omisión de dosis fu ela iatrogenia más frecuente com el 83,0%.

Ventilator-associated pneumonia: the influence of bacterial resistance, prescription errors, and de-escalation of antimicrobial therapy on mortality rates

Abstract Ventilator-associated pneumonia is the most prevalent nosocomial infection in intensive care units and is associated with high mortality rates (14–70%). Aim This study evaluated factors influencing mortality of patients with Ventilator-associated pneumonia (VAP), including bacterial resistance, prescription errors, and de-escalation of antibiotic therapy. Methods This retrospective study included 120 cases of Ventilator-associated pneumonia admitted to the adult adult intensive care unit of the Federal University of Uberlândia. The chi-square test was used to compare qualitative variables. Student's t-test was used for quantitative variables and multiple logistic regression analysis to identify independent predictors of mortality. Findings De-escalation of antibiotic therapy and resistant bacteria did not influence mortality. Mortality was 4 times and 3 times higher, respectively, in patients who received an inappropriate antibiotic loading dose and in patients whose antibiotic dose was not adjusted for renal function. Multiple logistic regression analysis revealed the incorrect adjustment for renal function was the only independent factor associated with increased mortality. Conclusion Prescription errors influenced mortality of patients with Ventilator-associated pneumonia, underscoring the challenge of proper Ventilator-associated pneumonia treatment, which requires continuous reevaluation to ensure that clinical response to therapy meets expectations.

Interações medicamentosas como causa de eventos adversos em idosos: os inibidores da enzima conversora da angiotensina (IECA) / Drug interactions as a cause of adverse events in the elderly: the angiotensin-converting enzyme inhibitors

Devido à idade avançada os idosos freqüentemente apresentam múltiplas patologias e necessitam fazer uso de mais de um medicamento, estando assim, sujeitos a interações medicamentosas indesejadas que podem resultar em eventos adversos. O trabalho tem como objetivo estudar as potenciais interações medicamentosas devidas ao uso simultâneo de dois ou mais fármacos em idosos. (...)