Prevalence of and factors affecting errors of medication omission at hospital discharge

Medication errors often occur at transitions in the health care system, specifically at patient discharge from the hospital. The objectives of this study are to determine the prevalence of errors of omission and identify factors influencing these errors. A retrospective chart review was conducted. Patient charts (N = 207) were analyzed to determine the medications they were intended to receive were picked up from the ambulatory pharmacy. Patient information collected included: age, gender, length of stay, primary diagnosis, number of medications prior to admission, number of comorbidities, and number of discharge medications. These variables were analyzed to determine if they influenced whether a patient experienced an error of medication omission after hospital discharge. The type of prescription (scheduled prescription, nonscheduled prescription, scheduled nonprescription, and nonscheduled nonprescription) was also analyzed to determine if it influenced whether patients experienced an error of omission. Of the total prescriptions (N = 1144), 34 percent were not filled at the ambulatory pharmacy and approximately 73 percent of the patients experienced at least one error of medication omission after discharge. Logistic regression determined that number of comorbidities (p = 0.033), psychiatric diagnosis (p = 0.005), number of medications given at discharge (p \u3c 0.001), and type of discharge prescription (p \u3c 0.001) statistically influenced whether patients experienced an error of medication omission at discharge. Implementing procedures in hospitals in order to prevent errors of medication omission may be an answer to the problem; however, manpower and workflow issues also will need to be considered. Patient safety and medication errors are complicated problems requiring complex solutions