Medication Errors Among Patients Admitted With Cardiovascular Disorders at the Critical Care Unit of Kenyatta National Hospital

Abstract

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. Studies on medication errors in the cardiovascular critical care unit are few, particularly in resource-limited settings. Broad Objective: To identify and classify medication errors and the risk factors for such errors among patients with cardiovascular disorders at the CCCU. Methods: A prospective cohort study was conducted. Patients’ prescriptions at Kenyatta National Hospital (KNH) CCU wards were reviewed. 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. Fischer’s exact or Pearson’s Chi-square tests established 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 (n=22, 55.0%), unemployed (n=30, 75.0%) and admitted through the outpatient department (n=20, 50.0%). The mean age was 47.7 (S D: 15.4) years and the average duration of admission was 7.6 (S D: 3.9) days. Ninety-seven prescriptions were reviewed from which 74 medication errors were identified. Most patients had at least one error (n=38, 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 10.3 times more likely to have an adverse effect compared to those without (p=0.012). Additionally, being employed reduced the odds of an adverse event by 0.3 (p=0.006). Conclusion: Critically ill patients with cardiovascular disease and acute kidney injury are at high risk of developing adverse drug events. Therefore, they require frequent medication reviews, dose adjustment and close monitoring by pharmacists.