dc.contributor.author | Okerosi, Elizabeth K | |
dc.date.accessioned | 2017-01-04T11:33:49Z | |
dc.date.available | 2017-01-04T11:33:49Z | |
dc.date.issued | 2016 | |
dc.identifier.uri | http://hdl.handle.net/11295/98866 | |
dc.description.abstract | Background
Medication discrepancies are defined as the variations in drug regimens during transition
from one health care worker or hospital to another. These medication discrepancies are either
intentional or unintentional and can lead to errors which can be detrimental to patients and in
the long term result in Medication Related Problems (MRPs). The unintentional discrepancies
can result in poor management of acute and chronic diseases, hospital readmission, and death.
Elderly diabetic patients are at high risk of medication discrepancies due to their multiple
chronic diseases resulting in different medication from the many healthcare providers they
are likely to see. The fact that they are elderly and undergoing normal age related changes
also puts them at high risk. Medication Reconciliation is therefore needed to identify and
rectify these discrepancies to promote patient safety.
Objectives
The main objective of the study was to measure the prevalence and identify risk factors for
medication discrepancies at admission in inpatient elderly diabetics at Kenyatta National
Hospital (KNH).
Methodology
A cross sectional study was carried out involving elderly diabetic patients aged 60 years and
above admitted to the medical wards at Kenyatta National Hospital (KNH) in 2016.
Convenient sampling was done to select the participants who met the inclusion criteria. The
participants who gave consent were recruited 24 hours after admission.
Data was abstracted from patient medical files, patient/caregiver interviews, clinical
discharge summaries and a physical check of drugs in use. A comparison of the medication
used before and after admission was done to determine the number of discrepancies. The
discrepancy types identified were classified into intentional, undocumented intentional and
unintentional discrepancies. Linear regression was done to identify risk factors for medication
discrepancies.
v
Results
Among the 163 patients recruited, 1089 medication discrepancies were identified. On
classification, 849 (78%) were intentional and 240 (22%) were unintentional. Among the
unintentional, 225 (94%) had the potential for harm with a prevalence rate of 1.4 per patient.
The most common discrepancy type is omissions 236 (98.3%). Only 94 (42%) of the 225
unintended discrepancies were resolved. Exactly, 63.2% of the patients had at least one
unintentional discrepancy (medication error).
Independent risk factors for number of discrepancies were the number of medications prior to
admission (adjusted β coefficient 1.377 (95% CI: 0.767, 1.987)), hypertension (β 0.992 (95%
CI: 0.094, 1.890)) and those with discharge forms from previous facilities (β 0.701 (95% CI:
0.010, 1.392)). Age had a negative association with medication discrepancies (β -0.755 (95%
CI: -1.284, -0.226)).
Conclusion
Medication discrepancies are common on admission. Our results support the importance of a
comprehensive medication history at hospital admission and putting in place a medication
reconciliation program, as demonstrated throughout the literature. | en_US |
dc.language.iso | en | en_US |
dc.publisher | University Of Nairobi | en_US |
dc.rights | Attribution-NonCommercial-NoDerivs 3.0 United States | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/us/ | * |
dc.subject | Medication Discrepancies On Admission Of Elderly Diabetics | en_US |
dc.title | Prevalence and risk factors for medication discrepancies on admission of elderly diabetics at Kenyatta National Hospital, Kenya. | en_US |
dc.type | Thesis | en_US |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |