Prevalence and Risk Factors for Medication Discrepancies on Admission of Elderly Diabetics at Kenyatta National Hospital, Kenya

Abstract

Background: Medications discrepancies are defined as the variations in drug regimens during transition from one health care worker or hospital to another.  The elderly diabetic patients are at risk of medication discrepancies due to their multiple comorbidities resulting in different medications from the many healthcare providers they are likely to see and physiological changes as a result of advanced age; hence the need for medication reconciliation.

Objectives: The main objective of the study was to measure the prevalence and identify risk factors for medication discrepancies at admission of inpatient elderly diabetics at Kenyatta National Hospital (KNH).

Methods: The study design was cross sectional descriptive study in which patients aged 60 years and above were recruited at the time of admission at the medical wards in 2016. Convenient sampling was conducted. A comparison of the medication used before and after admission was done to determine the number of discrepancies if any.  Admitting clinicians were interviewed to determine if discrepancies were intentional or not. Linear regression was conducted to determine risk factors for the number of errors per patient.

Results: Among the 163 patients recruited, 1089 medication discrepancies were identified, 63.2% of the patients had at least one unintentional discrepancy. The number of unintentional discrepancies per patient was 1.5 per patient. The most common discrepancy was omissions 236 (98.3%).  Independent risk factors for discrepancies were the number of medications prior to admission (adjusted β coefficient 1.377 (95% CI: 0.767, 1.987)), hypertension (β 0.992 (95% CI: 0.094, 1.890)) and those with discharge forms from other facilities (β 0.701 (95% CI: 0.010, 1.392)). Age had a negative association with medication discrepancies (β -0.755 (95% CI: -1.284, -0.226)).

Conclusion: The prevalence of medication discrepancies was high hence the need for medication reconciliation to reduce these discrepancies.