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Parkinson’s disease medications in hospital: A retrospective audit of prescribing and administration errors

Kum Chuan Leong, Stephanie Gibson.




Abstract

Background: Managing Parkinson’s disease (PD) medications in the acute hospital setting is complex. Mismanagement of PD medications such as inaccurate medication administration time and prescribing errors is common which can lead to the worsening of PD symptoms.

Aim and Objectives: The aim of the study was to identify the extent of PD medication prescribing and administration errors in adult inpatients and pharmacists’ impact across a Victorian metropolitan hospital.

Materials and Methods: A retrospective review analyzed a sample of 30 patients admitted between January and April 2022. PD medication orders (PDMO) and medication administration records (MAR) were reviewed; charting errors were identified based on reconciliation of PDMO with the pharmacist-led best-possible medication history (p-BPMH). Administration errors were identified through a review of MAR and PDMO charted time or p-BPMH documented administration time for each PD medication.

Results: A total of 60 PDMO and 469 administration instances were reviewed. About 83.3% (50) of PDMOs had at least one instance of delay or omission in administration. 45.0% (27) of PDMO charting errors led to delays or omissions in administration. The timing of administration was the most common charting error accounting for 18.3% (11) of PDMOs. Documentation of p-BPMH within 24 h of admission led to a reduction of charting errors (52.9% vs. 76.9%, respectively). PD medications that were administered on time compared to p-BPMH documented time and PDMO charted time were 48.6% (228/469) and 53.7% (252/469), respectively.

Conclusion: This study identified a high degree of PDMO charting and administration errors for patients with PD. Strategies to improve PD medication management are warranted.

Key words: Parkinson’s Disease; Hospital Medication Management; Pharmacist-Led Medication History; Prescribing Errors; Administration Errors






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