(186) Medication Errors Among Patients Admitted with Cardiovascular Disorders at The Critical Care Unit of a National Referral Hospital in Kenya

Friday, August 26, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 517

Presenting Author(s)

Sylvia Atisa Opanga, PhD
– Dr, University of Nairobi, Department of Pharmacy University of Nairobi, Nairobi, Nairobi, Kenya

Co-Author(s)

Doryne Mbula, M Pharm Clinical Pharmacy
– Clinical Pharmacist, Ministry of Health Kenya, Nairobi, Nairobi Area, Kenya
Faith A. Okalebo, PhD
– Professor, UNiversity of Nairobi, Nairobi, Kenya

Background: Drugs used to treat cardiovascular disorders are associated with the highest rates of medication errors. Patients in the cardiovascular critical care unit (CCCU) are inherently predisposed to high mortality and morbidity rates owing to complex management approaches and deranged physiological parameters.

Objectives: To identify and classify medication errors and the associated risk factors among patients with cardiovascular disorders at the CCCU.

Methods: A prospective cohort study was conducted at the Kenyatta National Hospital (KNH) CCCU wards. Approval for this study was granted by the KNH/UoN Ethics Review Committee. Forty patients were selected through convenient sampling. A pre-designed questionnaire was used to extract on patient’s sociodemographic and clinical characteristics from their files. Data was analyzed descriptively and inferentially using Microsoft Excel 2016 and STATA version 13.0. Fischer’s exact or Pearson’s Chi-square tests were used to establish the association between the predictor variables and the medication errors. A regression analysis identified the independent predictors of medication errors at P< 0.05.

Results: Most participants were female (55.0%), unemployed (75.0%, ) and admitted through the outpatient department (50.0% ). The mean age was 47.7 (SD: 15.4) years and the average duration of admission was 7.6 (SD: 3.9) days. Hypertension (27.5%, ), hypertensive urgency (22.5%,), and acute decompensated heart failure (7.5%,) were the primary cardiovascular diagnoses. Ninety-seven prescriptions were reviewed from which 74 medication errors were identified. Most patients had at least one error (95.0%). The main types of errors were potential drug-drug interactions (n=37, 92.5%) and drug choice problem error (n=18, 45.0%). Patients with Acute kidney injury were 11.6 times more likely to have an adverse effect compared to those without (P=0.020). Being employed reduced the odds of an adverse event by 0.3 (P=0.006).

Conclusions: Critically ill patients with cardiovascular disease and acute kidney injury are at high risk of developing adverse drug events. They therefore require frequent medication reviews, dose adjustment and close monitoring by pharmacists.