Abstract:
Abstract
Background: Unintended medication discrepancy is a highly prevalent problem in patients at
transition points of care. Medication reconciliation by clinical pharmacists is a widely accepted tool
for the identification and resolution of unintended medication discrepancies. Hence, this study was
aimed at assessing unintended medication discrepancies identified through medication reconciliation
and associated factors upon admission to the internal medicine wards.
Methods: This cross-sectional study was conducted at Felege Hiwot and Tibebe Ghion
comprehensive specialized hospitals in Bahir Dar city, Northwest Ethiopia from May 01 to July 30,
2021. Clinical pharmacists collected the data by using data abstraction format prepared based on
previous studies, prospectively. Data was entered into the EpiData software (version 4.6.0.0), and
then exported to SPSS® version 25.0. Mean, median, frequency, and proportion were used for the
descriptive analysis. A binary logistic regression analysis was carried out to identify associated
factors. A p-value of < 0.05 was used to declare the statistical significance.
Results: Among 635 patients, 248 (39.1%) (95% CI = 35.2, 43.0) of patients had at least one
unintended medication discrepancy, and 388 (30.2%) medications were involved in unintended
medication discrepancies. The most frequent type of unintended medication discrepancy was
omission (41.75%), followed by wrong dose (21.9%). Amongst interventions made by clinical
pharmacists, 75.3% of them were accepted by physicians. Polypharmacy at admission (AOR = 5.47;
95% CI = 3.52, 8.48), age ? 65 years (AOR = 2.13; 95% CI = 1.40, 3.24), number of information
sources (AOR = 2.83; 95% CI = 1.98, 4.05), medium adherence (AOR = 2.93; 95% CI = 1.19, 7.16)
and low adherence (AOR = 11.13; 95% CI = 5.17, 23.98), and number of comorbidities (AOR =
1.29; 95% CI = 1.07, 1.56) were variables significantly associated with unintended medication
discrepancies.
Conclusion: More than one-third of patients had at least one unintended medication discrepancy, and
omissions followed by wrong dose were the most common types of unintended medication
discrepancies. Most of interventions made by clinical pharmacists were accepted. Age ? 65 years,
polypharmacy at admission, number of information sources, medium and low adherence, and
increasing number of comorbidity were significantly associated independent factors with unintended
medication discrepancies.
Keywords: Medication discrepancy, medication reconciliation, hospital admission, clinical
pharmacy, medication error, pharmaceutical intervention, Bahir Dar city Ethiopia
