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Drug therapy
Medication discrepancies in transition of care of hospitalised children in Brazil: a multicentric study
  1. Giulyane Targino Aires-Moreno1,
  2. Thaciana dos Santos Alcântara1,
  3. Dyego Carlos Souza Anacleto de Araújo1,
  4. Simony da Mota Soares2,
  5. Vanessa Terezinha Gubert3,
  6. Vanessa Marcon de Oliveira3,
  7. Cristiane Munaretto Ferreira3,
  8. Erica Freire Vasconcelos-Pereira3,
  9. Ana Rafaela Pires Lira4,
  10. Clarice Chemello4,
  11. Layse Maria Soares de Oliveira5,
  12. Alfredo Dias de Oliveira-Filho5,
  13. Divaldo Lyra Jr1
  1. 1 Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, Sao Cristóvão, Brazil
  2. 2 University Hospital, Federal University of Sergipe, Sao Cristóvão, Brazil
  3. 3 Pharmacy School Professor Ana Maria Cervantes Baraza, Faculty of Pharmacy, Food and Nutrition, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
  4. 4 Center for Pharmaceutical Care Studies, Department of Social Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil
  5. 5 School of Nursery and Pharmacy (ESENFAR), Federal University of Alagoas, Maceio, Brazil
  1. Correspondence to Dr Divaldo Lyra Jr, Pharmacy, Federal University of Sergipe, Sao Cristovao 49100-000, Brazil; lepfs.ufs{at}gmail.com

Abstract

Objective To determine the incidence of medication discrepancies in transition points of care of hospitalised children.

Design A prospective observational multicentre study was carried out between February and August 2019. Data collection consisted of the following steps: sociodemographic data collection, clinical interview with the patient’s caregiver, review of patient prescriptions and evaluation of medical records. Medication discrepancies were classified as intentional (documented or undocumented) and unintentional. In addition, discrepancies identified were categorised according to the medication discrepancy taxonomy. Unintentional discrepancies were assessed for potential clinical harm to the patient.

Setting Paediatric clinics of four teaching hospitals in Brazil.

Patients Children aged 1 month–12 years.

Findings A total of 248 children were included, 77.0% (n=191) patients had at least one intentional discrepancy; 20.2% (n=50) patients had at least one unintended discrepancy and 15.3% (n=38) patients had at least one intentional discrepancy and an unintentional one. The reason for the intentional discrepancy was not documented in 49.6% (n=476) of the cases. The most frequent unintentional discrepancy was medication omission (54.1%; n=66). Low potential to cause discomfort was found in 53 (43.4%) unintentional discrepancies, while 55 (45.1%) had the potential to cause moderate discomfort and 14 (11.5%) could potentially cause severe discomfort.

Conclusions Although most medication discrepancies were intentional, the majority of these were not documented by the healthcare professionals. Unintentional discrepancies were often related to medication omission and had a potential risk of causing harm to hospitalised children.

  • social work
  • health services research

Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information: lepfs.ufs@gmail.com.

https://doi.org/10.1136/archdischild-2020-320225

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplemental information: lepfs.ufs@gmail.com.

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    Footnotes

    • Contributors GTA-M, TdSA, DCSAdA, SdMS, VTGdM, VMdO, CMF, EFV-P, ARPL and LMSdO contributed to design, data collections and data critical review. GTA-M, CC, LMSdO and DL-J contributed to analysis and results interpretation.

    • Funding This study was funded by the Notice 428458/2016-5 of the National Council for Scientific and Technological Development.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.