Peterson JF, Shi Y, Denny JC, Matheny ME, Schildcrout JS, Waitman LR, Miller RA. Prevalence and Clinical Significance of Discrepancies within Three Computerized Pre-Admission Medica AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium. 2010(2010). 642-6. PMID: 21347057 [PubMed] PMCID: PMC3041392
Inaccurate records of pre-admission medication exposure have been identified as a major source of medication error. Authors collected records of patients' pre-admission medications: 1) the most recent outpatient medication list ("EMR"), 2) the medication list recorded by admitting providers ("H&P"), and 3) a list generated by a medication reconciliation process conducted by nursing staff ("PAML"). Forty-eight sets of pre-admission records composed of 1087 medication entries were compared to a reference standard generated by trained study staff conducting an independent interview. Sensitivity was greatest for PAML (85%), compared to EMR (76%) and H&P (76%) sources. However, positive predictive value was greatest for the H&P source at 96% vs 88% and 91% for PAML and EMR sources respectively. Potentially harmful medication discrepancies were found within all lists. The authors concluded no single list was sufficiently accurate to avoid serious medication errors.