PATIENT SAFETY
changes in medication regimes and may also be a chance for omissions and discontinuations or additions thereby giving opportunities for adverse drug reactions. Many discrepancies at transitions of care do not relate to harm but a considerable proportion do. In a systematic review between 11% and 59% of discrepancies at admission and discharge were considered to have potential for harm.9
A study which looked at ADRs and the consequence of admission in UK found 6.5% of patients admissions to two acute hospitals were related to adverse drug reactions which directly lead to admissions in 80% of cases.10
Conclusion
Potential solutions to harm caused by medication at various points of care and in many different settings will involve, people, patients, technology, systems and processes. It will not be simple to resolve. There are specific activities being rolled out across the NHS with potential to reduce the numbers of patients harmed. NHS Improvement , the Care Collaboratives and the Academic Health Networks have all got ongoing projects to find solutions that are practical and effective for widespread implementation.
References
1 Manchester Centre for Health Economics, Policy Research Unit in Economic Evaluation of Health and Care Interventions. Universities of Sheffield and York. Prevalence and economic burden of
Globally, the prevalence of polypharmacy is set to rise as the population ages and more people suffer from long term conditions. There is evidence, but not yet enough to support regular medication reviews to reduce the opportunity for drug-drug and drug-disease interactions.
medication errors in the NHS in England. 2018 Accessed at
http://www.eepru.org.uk/prevalence- and-economic-burden-of-medication-errors-in-the- nhs-in-england-2/
2 World Health Organization.(2019). Medication safety in high-risk situations. Accessed at https://
apps.who.int/iris/handle/10665/325131.
3 WHO 5 Moments for Medication Safety Accessed at
https://www.who.int/patientsafety/medication- safety/5moments/en/
4 WHO 2019 Medication in high risk situations. Technical report Accessed at
https://www.who.int/ patientsafety/medication-safety/technical-reports/en/
CSJ
5 Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE What is polypharmacy? A systematic review of definitions. BMC Geriatrics. 2017;17:230.
https://doi.org/10.1186/s12877-017-0621-2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5 635569/
6 WHO 2019 Medication safety in Polypharmacy. Technical report. Accessed at
https://www.who.int/ patientsafety/medication-safety/technical-reports/en/
Low impact laparoscopy
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7 The Simpathy Consortium. 2017 Polypharmacy management by 2030: a patient safety challenge. Accessed at
http://www.simpathy.eu/sites/ default/files/Managing_polypharmacy2030-web.pdf
8 WHO 2019 Medication Safety in Transitions of Care Technical report. Accessed at
https://www.who.int/ patientsafety/medication-safety/technical- reports/en/
9 Tam VC, Knowles SR, Cornish PL, Fine N, Marchesano R, Etchells EE. Frequency, type and clinical importance of medication history errors at admission to hospital: a systematic review. CMAJ. 2005;173 (5):510–5. Accessed at
https://doi.org/10.1503/cmaj.045311
10
https://www.ncbi.nlm.nih.gov/pubmed/16129874 11 Pirmohamed M, James S, Meakin S, Green C, Scott AK, Walley TJ et al. Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients. BMJ. 2004;329(7456):15–9. Accessed at
https://doi.org/10.1136/bmj.329.7456.15 https://www.ncbi.nlm.nih.gov/pubmed/15231615
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