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Drug-related problems in medical wards with a computerized physician order entry system
P Bedouch1, B Allenet, A Grass
1Pôle pharmacie, Centre Hospitalier-Universitaire de Grenoble, Grenoble, France. PBedouch@chu-grenoble.fr
Journal of Clinical Pharmacy and Therapeutics
|March 3, 2009
Summary
Drug-related problems (DRPs) remain common despite computerized physician order entry (CPOE) systems. Clinical pharmacists on medical rounds can identify these DRPs to improve patient safety.
Area of Science:
- Clinical Pharmacy
- Health Informatics
- Patient Safety
Background:
- Computerized physician order entry (CPOE) systems aim to reduce medication errors.
- However, drug-related problems (DRPs) can persist even with CPOE implementation.
Purpose of the Study:
- To identify and estimate the prevalence of DRPs in patients using a CPOE system.
- To assess the role of clinical pharmacists in routine medical rounds for DRP detection.
Main Methods:
- A prospective 18-month study involving seven clinical pharmacists.
- Analysis of 29,016 medication orders for 8152 patients.
- DRPs identified using a structured order review by two independent pharmacists.
Main Results:
- 2669 DRPs were identified in 1564 patients, a rate of 33 DRPs per 100 admissions.
- Most common DRPs included non-conformity to guidelines (29.5%), improper administration (19.6%), and drug interactions (16.7%).
- Cardiovascular drugs, antibiotics, and analgesics were the most frequently implicated drug classes.
Conclusions:
- DRPs are prevalent even with CPOE, highlighting the need for ongoing vigilance.
- Clinical pharmacists' routine participation in medical rounds is effective for identifying DRPs.
- Pharmacist involvement can significantly enhance patient safety by addressing DRPs.
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