Project 3. Epidemiology and Prevention of Medication Errors in Psychiatric Inpatients
The pharmacologic treatment of psychiatric disorders has improved tremendously in recent years. Specifically, many new psychopharmacologic compounds have been developed. A number of acute and chronic psychiatric illnesses can now treated much more effectively than even a decade ago. However, while these new agents have better side effect profiles than many of the older drugs, the potential for medication error and adverse drug events continues to be an important problem. Furthermore, the psychiatric population is growing older, and most such patients are receiving many medications that may be unfamiliar to psychiatric providers.
While substantial information is available regarding the frequency and prevention of medication errors (MEs) and adverse drug events (ADEs) in inpatients, most of these studies have not included psychiatric patients
(1). Specific populations such as critically ill patients and oncology patients have been demonstrated to pose unique challenges to safe medication use
(2). Some of the limited available data suggest that the psychiatric inpatients represent another unique, high-risk population
(3). In this prospective study, we found that ADEs were disproportionately frequent on psychiatric units compared to medical and surgical units, and moreover this group was especially costly.
Furthermore, while some prevention strategies have been found to be effective in inpatients, the most effective approaches may be different in psychiatry, especially since very high doses of some psychiatric drugs are sometimes used with good effect in the inpatient setting, so that simple dose checks might have little utility.
Thus, we propose to study the epidemiology of serious MEs (including preventable ADEs and non-intercepted potential ADEs) in hospitalized psychiatry patients and then use these data to develop an intervention, which we will then test prospectively.
