Analysis of hospital records suggests there are several points at which errors in medication are more likely to be made for cardiology patients, according to an article in the June 23rd issue of the Archives of Internal Medicine.

Nancy M. Allen LaPointe, Pharm.D., and James G. Jollins, M.D., reviewed the experience of a clinical pharmacist on the cardiology wards at a major U.S. university medical center between September 1, 1995 and February 18, 2000. The pharmacist was trained in cardiovascular medicine and participated in patient care with physicians and nurses in the cardiology units. The researchers identified and classified medication errors according to the type of error, medications involved, personnel involved, stage of drug administration involved, and time of year in which the errors occurred.

During the study period, 24,538 patients were admitted to cardiology wards and there were 4,768 pharmacist interventions related to medication errors that were corrected, or 24 errors per 100 admissions. The most common errors included wrong drug (36 percent) or wrong dose (35.3 percent), and cardiovascular medications were involved in 41.2 percent of the errors found.

The researchers also found that the most common time for an error to occur was during the transition from outpatient to inpatient status. More errors were also noted during the transition period of physicians in training and during the time period when new physicians entered training.

"Three notable medication error trends were identified in our study, including: (1) a high number of errors attributed to lack of knowledge of the patient's drug therapy before admission, (2) an increase in errors during periods of house staff transition, and (3) a gradual increase in the number of medication errors during the study period," wrote the authors. "These findings confirm the potential for pharmacist participation in physician rounds to identify and markedly decrease medication errors."

The researchers describe two techniques for helping to reduce errors, "The first is the development of a system that provides health care providers with accurate, up-to-date medication information at the point of care. The second is more focused education and backup for new interns during their initial months of training.

The authors concluded, “The large and increasing numbers of potential adverse drug events identified through routine review by a clinical pharmacist strongly support the role of pharmacists in assuring patient safety."