Development and validation of a Score to Assess Risk of Medication Errors detected during medication reconciliation process at admission in Internal Medicine Unit: SCOREM study

Valerie Audurier (1) , C. Roubille (1, 2) , F. Manna (1, 3) , L. Zerkowski (1) , M. Faucanie (1) , V. Macioce (1) , A. Castet‐nicolas (1, 4) , A. Jalabert (1) , M. Villiet (1) , Pierre Fesler (1, 2) , L. Lohan‐descamps (1, 2) , Cyril Breuker (1, 2)

1 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
2 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
3 UM - Université de Montpellier
4 IRCM - U1194 Inserm - UM - Institut de Recherche en Cancérologie de Montpellier

Background: Medication errors (ME) can be reduced through preventive strategies such as medication reconciliation. Such strategies are often limited by human resources and need targeting high risk patients.Aims: To develop a score to identify patients at risk of ME detected during medication reconciliation in a specific population from internal medicine unit.Methods: Prospective observational study conducted in an internal medicine unit of a French University Hospital from 2012 to 2016. Adult hospitalised patients were eligible for inclusion. Medication reconciliation was conducted by a pharmacist and consisted in comparing medication history with admission prescription to identify MEs. Risk factors of MEs were analysed using multivariate stepwise logistic regression model. A risk score was constructed using the split-sample approach. The split was done at random (using a fixed seed) to define a development data set (N = 1256) and a validation sample (N = 628). A regression coefficient-base scoring system was used adopting the beta-Sullivan approach (Sullivan's scoring).Results: Pharmacists detected 740 MEs in 368/1884 (19.5%) patients related to medication reconciliation. Female gender, number of treatments >7, admission from emergency department and during night or weekend were significantly associated with a higher risk of MEs. Risk score was constructed by attributing 1 or 2 points to these variables. Patients with a score ≥3 (OR [95% CI] 3.10 [1.15-8.37]) out of 5 (OR [95% CI] 8.11 [2.89-22.78]) were considered at high risk of MEs.Conclusions: Risk factors identified in our study may help prioritising patients admitted in internal medicine units who may benefit the most from medication reconciliation (ClinicalTrials.gov number NCT03422484).

Domaines: Sciences du Vivant [q-bio]

Valerie Audurier, C. Roubille, F. Manna, L. Zerkowski, M. Faucanie, et al.. Development and validation of a Score to Assess Risk of Medication Errors detected during medication reconciliation process at admission in Internal Medicine Unit: SCOREM study. International Journal of Clinical Practice, 2021, ⟨10.1111/ijcp.13663⟩. ⟨hal-02914734⟩