TY - JOUR
T1 - Prescribing errors in post - COVID-19 patients
T2 - prevalence, severity, and risk factors in patients visiting a post - COVID-19 outpatient clinic
AU - Mahomedradja, Rashudy F
AU - van den Beukel, Tessa O
AU - van den Bos, Maaike
AU - Wang, Steven
AU - Kalverda, Kirsten A
AU - Lissenberg-Witte, Birgit I
AU - Kuijvenhoven, Marianne A
AU - Nossent, Esther J
AU - Muller, Majon
AU - Sigaloff, Kim C E
AU - Tichelaar, Jelle
AU - van Agtmael, Michiel A
N1 - Funding Information: This project was funded by the Medication Committee of the Amsterdam UMC. Funding Information: We thank all colleagues of the post - COVID-19 outpatient clinical and the members of the Amsterdam UMC Post COVID-19 study group, in particular Illaa Smesseim and Rosalie Huijsman, for their collaboration. We also would like to thank all participating fellows clinical pharmacy, Roland van den Berg; Anouk Braam; Bojan Nicolik; Mirjam Slijkhuis for their participation in the weekly meetings. Finally, this study was a project initiated within the Medication Committee of Amsterdam UMC. We are grateful to all members for supporting this project and our team. Mahomedradja van den Beukel van den Bos Lissenberg-Witte Wang Kalverda-Mooij Nossent Kuijvenhoven Tichelaar Sigaloff Muller Agtmael Study conception and design X X X Acquisition of data X X X X X X Analysis and interpretation of data X X X X Drafting of manuscript X X X X X X X Critical revision X X X X X X X X X X X X Publisher Copyright: © 2022, The Author(s).
PY - 2022/12/1
Y1 - 2022/12/1
N2 - BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has challenged healthcare globally. An acute increase in the number of hospitalized patients has necessitated a rigorous reorganization of hospital care, thereby creating circumstances that previously have been identified as facilitating prescribing errors (PEs), e.g. a demanding work environment, a high turnover of doctors, and prescribing beyond expertise. Hospitalized COVID-19 patients may be at risk of PEs, potentially resulting in patient harm. We determined the prevalence, severity, and risk factors for PEs in post-COVID-19 patients, hospitalized during the first wave of COVID-19 in the Netherlands, 3 months after discharge.METHODS: This prospective observational cohort study recruited patients who visited a post-COVID-19 outpatient clinic of an academic hospital in the Netherlands, 3 months after COVID-19 hospitalization, between June 1 and October 1 2020. All patients with appointments were eligible for inclusion. The prevalence and severity of PEs were assessed in a multidisciplinary consensus meeting. Odds ratios (ORs) were calculated by univariate and multivariate analysis to identify independent risk factors for PEs.RESULTS: Ninety-eight patients were included, of whom 92% had ≥1 PE and 8% experienced medication-related harm requiring an immediate change in medication therapy to prevent detoriation. Overall, 68% of all identified PEs were made during or after the COVID-19 related hospitalization. Multivariate analyses identified ICU admission (OR 6.08, 95% CI 2.16-17.09) and a medical history of COPD / asthma (OR 5.36, 95% CI 1.34-21.5) as independent risk factors for PEs.CONCLUSIONS: PEs occurred frequently during the SARS-CoV-2 pandemic. Patients admitted to an ICU during COVID-19 hospitalization or who had a medical history of COPD / asthma were at risk of PEs. These risk factors can be used to identify high-risk patients and to implement targeted interventions. Awareness of prescribing safely is crucial to prevent harm in this new patient population.
AB - BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has challenged healthcare globally. An acute increase in the number of hospitalized patients has necessitated a rigorous reorganization of hospital care, thereby creating circumstances that previously have been identified as facilitating prescribing errors (PEs), e.g. a demanding work environment, a high turnover of doctors, and prescribing beyond expertise. Hospitalized COVID-19 patients may be at risk of PEs, potentially resulting in patient harm. We determined the prevalence, severity, and risk factors for PEs in post-COVID-19 patients, hospitalized during the first wave of COVID-19 in the Netherlands, 3 months after discharge.METHODS: This prospective observational cohort study recruited patients who visited a post-COVID-19 outpatient clinic of an academic hospital in the Netherlands, 3 months after COVID-19 hospitalization, between June 1 and October 1 2020. All patients with appointments were eligible for inclusion. The prevalence and severity of PEs were assessed in a multidisciplinary consensus meeting. Odds ratios (ORs) were calculated by univariate and multivariate analysis to identify independent risk factors for PEs.RESULTS: Ninety-eight patients were included, of whom 92% had ≥1 PE and 8% experienced medication-related harm requiring an immediate change in medication therapy to prevent detoriation. Overall, 68% of all identified PEs were made during or after the COVID-19 related hospitalization. Multivariate analyses identified ICU admission (OR 6.08, 95% CI 2.16-17.09) and a medical history of COPD / asthma (OR 5.36, 95% CI 1.34-21.5) as independent risk factors for PEs.CONCLUSIONS: PEs occurred frequently during the SARS-CoV-2 pandemic. Patients admitted to an ICU during COVID-19 hospitalization or who had a medical history of COPD / asthma were at risk of PEs. These risk factors can be used to identify high-risk patients and to implement targeted interventions. Awareness of prescribing safely is crucial to prevent harm in this new patient population.
KW - COVID-19
KW - Clinical pharmacology
KW - Pharmacotherapeutic stewardship
KW - Prescribing errors
UR - http://www.scopus.com/inward/record.url?scp=85125839950&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s12873-022-00588-7
DO - https://doi.org/10.1186/s12873-022-00588-7
M3 - Article
C2 - 35247982
SN - 1471-227X
VL - 22
SP - 35
JO - BMC Emergency Medicine
JF - BMC Emergency Medicine
IS - 1
M1 - 35
ER -