Medication discontinuity errors in the perioperative period.
van Waes JA, de Graaff JC, Egberts AC, van Klei WA.
Departments of Perioperative care and Emergency, University Medical Centre Utrecht, the Netherlands. j.a.r.vanwaes@umcutrecht.nl
Acta Anaesthesiol Scand. 2010 Nov;54(10):1185-91. doi: 10.1111/j.1399-6576.2010.02318.x.
Abstract
BACKGROUND: Inappropriate withdrawal or continuation of medication in the perioperative period is associated with an increased risk for adverse events. To reduce this risk, it is important that patients take their regular medication as prescribed. We evaluated this treatment objective by studying the frequency and reasons for errors related to medication discontinuity in the perioperative period. METHODS: Patients scheduled for non-cardiac surgery were included in this cross-sectional study. Perioperative medication intake was assessed at the holding area of the operation theatre complex and on the ward during the first 24 h after surgery. Medication intake data were obtained from medical records and by questioning patients and compared with pre-operative instructions. RESULTS: The study included 701 patients, of whom 485 (69%) used regular medication. Medication was incorrectly taken or discontinued before surgery in 27% of the patients. In 57% of these patients, the reason for incorrect intake was an unclear or a falsely understood instruction before surgery. Post-operative medication errors occurred in 26% of the patients. CONCLUSION: Medication errors occur frequently in the perioperative period, even in the era of an electronic medication file. Errors in prescription, administration and intake of medication are not easily solved because no single health care professional is responsible for adequate intake of medication in surgical patients. The anaesthesiologist should take on a more prominent role in regulating perioperative medication intake in surgical patients.
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