Medication, allergy, and adverse drug event discrepancies in ambulatory care

A first step in reducing medication errors is for health care workers to be aware of a patient's medications, allergies, and any previously documented adverse drug events (ADEs). This study sought to determine the frequency of medication and allergy/ADE-related discrepancies in a family medicine residency clinic.

Patients were contacted prior to appointments and asked to bring in prescription and over-the-counter medications. A research assistant interviewed 157 patients and recorded each drug a patient was taking, together with dosage, dosing frequency, known allergies, and demographic information. This information was then compared to similar information in the medical record.

Overall, 97% of patients had at least one discrepancy between medications listed in the medical record and medications they were taking, and 32% had an allergy/ADE discrepancy. Discrepancies were highest for women, those with cardiovascular disease, and those hospitalized within the last year. Only the total number of medications was predictive of a discrepancy, however, accounting for 25% of the variability.

A higher medication discrepancy rate existed in this family medicine residency clinic than the 26%--76% rate that is documented in the literature. The results point to a need for better medication, allergy, and ADE awareness.