Unintentional medication discrepancies occurred in 12.5% of orders and tripled odds of postoperative ADEs (OR 3.06) in cancer surgery patients, affecting 16.4% of patients.
Do unintentional medication discrepancies increase the risk of postoperative adverse drug events in adult patients undergoing major cancer surgery?
Unintentional medication discrepancies significantly increase the risk of postoperative adverse drug events in patients undergoing major cancer surgery.
Absolute Event Rate: 0% vs 0%
Abstract Aim To understand regular medication management processes in the postoperative period for patients having major cancer surgery, and to evaluate whether medication discrepancies were associated with postoperative adverse drug events (ADEs). Method A prospective cohort of 500 adult patients, undergoing planned major cancer surgery at a Melbourne specialist cancer hospital, was followed from surgery to day 30 postoperatively. Regular medication discrepancies were assessed across transitions of care up to five days postoperatively and at discharge. Adverse drug events were monitored up to 30 days after surgery. Multivariable logistic regression was used to identify predictors of medication discrepancies and ADEs. Results Among 7254 medication orders for 500 patients, 12.5% ( n = 905) of orders resulted in unintentional medication discrepancies. Polypharmacy (OR = 1.32; 95%CI: 1.21–1.44; p < 0.001) and length of stay (OR = 1.07; 95%CI: 1.03–1.12; p = 0.001) were significant predictors of unintentional medication discrepancies. ADEs occurred in 16.4% of patients ( n = 82). In multivariable analysis, the odds of experiencing an ADE were significantly higher among patients who had unintentional discrepancies ( vs . those with intentional discrepancies; OR = 3.06; 95%CI: 1.66–5.64; p < 0.001), older age (OR = 1.05; 95%CI: 1.02–1.08; p < 0.001), polypharmacy (OR = 1.20; 95%CI: 1.08–1.33; p < 0.001), higher acuity care admission (OR = 2.46; 95%CI: 1.33–4.54; p = 0.004) and prolonged hospital length of stay (OR = 1.07; 95%CI: 1.02–1.12; p = 0.002). Cardiovascular and alimentary tract medications were most commonly implicated in both discrepancies and ADEs. Conclusion Unintentional medication discrepancies are associated with postoperative ADEs in patients having cancer surgery. Targeted strategies—especially for older patients, those with polypharmacy, and extended hospital stays—are essential to enhance medication safety across perioperative transitions.
Mehrabifar et al. (Wed,) reported a other. Unintentional medication discrepancies occurred in 12.5% of orders and tripled odds of postoperative ADEs (OR 3.06) in cancer surgery patients, affecting 16.4% of patients.