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Pharmacist interventions in high-risk obstetric inpatient unit: a medication safety issue
Nice M O Silva1, Mariana R Gnatta2, Marília B Visacri1
1Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Alexander Fleming, 101, Campinas, SP, Brazil.
Objectives:
The aim of this study was to report number, type and severity of prescribing errors and pharmacist interventions in high-risk pregnant and postpartum women.
Design:
A prospective cross-sectional, observational study.
Setting:
A high-risk obstetric inpatient unit of a Women's Hospital in Brazil.
Participants:
About 1826 electronic prescriptions for 549 women in the high-risk obstetrics inpatient unit were included.
Interventions:
When the pharmacist detected potential prescribing errors, interventions were suggested.
Main Outcome Measures:
Prescriptions were evaluated by clinical pharmacist to identify the type, frequency and severity of prescribing errors and rate of clinical pharmacist intervention acceptance in a high-risk obstetric inpatient.
Results:
A total of 1826 prescriptions were reviewed with 128 errors (7.0%). The most frequent errors were drug interaction (43.8%), incorrect frequency (21.5%) and improper dose (13.1%). One-hundred and sixty-eight interventions were made by pharmacists, 98.8% of which were accepted by prescribers. Higher maternal age (OR 1.0 (95%CI 1.0-1.1)), higher number of prescribed medications (OR 1.2 (95%CI 1.1-1.3)), obstetric conditions (OR 2.2 (95%CI 1.4-3.3)) and non-breastfeeding postpartum women (OR 3.9 (95% CI 2.5-6.1)) were the independent factors associated with prescribing errors identified through multivariate analysis.
Conclusions:
The most common prescription errors related to drug interactions, incorrect frequency and higher number of prescribed medications. The rate of pharmacist acceptance intervention was high.
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