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Effect and associated factors of a clinical pharmacy model in the incidence of medication errors in the hospital Pablo Tobón Uribe eacpharmodel study: stepped wedge randomized controlled Trial (NCT03338725)

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Abstract

Background The World Health Organization considers medication errors to be an issue that requires attention at all levels of care, to reduce the severe and preventable harm related to drug therapy. Different standards for clinical pharmaceutical practices have been proposed by various organizations across the world, where the pharmacist, as part of the multidisciplinary health team, can help improve patient safety. Objective To assess the impact of the introduction of a clinical pharmacy practice model on medication error in patients of a university hospital. Setting The study was conducted in a tertiary care hospital, Medellín, Colombia. Methods A randomized, controlled cluster-wedge staggered trial with a duration of 14 months was conducted to compare the clinical pharmacy practice model with the usual care process in the hospital. Five hospital health care units were included, which were initially assigned to the control group, and after an observation period of 2 months, they were randomly assigned to the intervention group. The trial protocol was registered in ClinicalTrials.gov (identifier NCT03338725). Main outcome measure The incidence of medication errors in hospitalized patients was the main outcome measure. Results The incidence of medication error was 13.3% and 22.8% for the intervention group and control group, respectively. The probability of presenting a medication error was 48% lower when the patient was in the intervention group (RR 0.52; 95% CI: 0.34–0.79). The probability of presenting a medication error over time was 44% lower in the intervention group (p = 0.0005); meanwhile, the resolution of a medication error over time was 70% higher in the intervention group (p = 0. 0029). Conclusion The clinical pharmacy practice model, made up of strategies focused on reducing medication errors, significantly reduces medication errors in patients during hospitalization compared with usual practice. This work assessed the effect of a clinical pharmacy model on the incidence of medication errors and demonstrated its effectiveness in reducing these errors in hospitalized patients.

Trial registration ClinicalTrials.gov, NCT03338725. Registered on 9 November 2017. First patient randomized on February 2, 2018.

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Acknowledgements

We would like to thank the Clinical Pharmacy Section, Pharmacy Department, Hospital Pablo Tobón Uribe, Medellín, Colombia. The authors express their gratitude to the Department of Pharmacy, the Faculty of Pharmaceutical and Food Sciences and the University of Antioquia for supporting the project, as well as to the pharmacist Yasmith Manosalva and physician Natalia Zapata for their contributions to patient evaluation.

Funding

The Pharmaceutical Promotion and Prevention Group received financial support from the Committee for Development Research (CODI) and sustainability program (2018–2019), Universidad de Antioquia.

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Authors and Affiliations

  1. Grupo Promoción y Prevención Farmacéutica, Facultad de Ciencias Farmacéuticas, Universidad de Antioquia UdeA, Calle 70 No 52-21, Medellín, Colombia

    Johan Granados, Pedro Amariles, Andrés-Felipe Valencia-Quintero & Andrea Salazar-Ospina

  2. Grupo de Investigación en Tecnología en Regencia de Farmacia, Universidad de Antioquia UdeA, Calle 70 No 52-21, Medellín, Colombia

    Johan Granados & Andrea Salazar-Ospina

  3. Hospital Pablo Tobón Uribe, Calle 78B #69-240, 05001000, Medellín, Antioquia, Colombia

    Juan Pablo Botero-Aguirre, Natalia Andrea Ortiz-Cano & Andrés-Felipe Valencia-Quintero

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  1. Johan Granados
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  2. Pedro Amariles
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  3. Juan Pablo Botero-Aguirre
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  4. Natalia Andrea Ortiz-Cano
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Correspondence to Johan Granados.

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Granados, J., Amariles, P., Botero-Aguirre, J.P. et al. Effect and associated factors of a clinical pharmacy model in the incidence of medication errors in the hospital Pablo Tobón Uribe eacpharmodel study: stepped wedge randomized controlled Trial (NCT03338725). Int J Clin Pharm 44, 439–447 (2022). https://doi.org/10.1007/s11096-021-01361-9

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