Drug Record Discrepancies in an Outpatient Electronic Medical Record: Frequency, Type, and Potential Impact on Patient Care at a Hemodialysis Center

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Abstract
Background. Patients who require hemodialysis take many drugs. Electronic drug records may be discrepant with what patients are actually taking. Record discrepancies are a potential source of drug‐related problems. We sought to determine the extent to which drug record discrepancies occur in a hemodialysis population.Methods. This was a prospective observational study of patients enrolled in a pharmacist clinic at an outpatient hemodialysis center from August‐December 2001. Patients participated in monthly drug interviews conducted by a pharmacist, during which patient drug use was determined. Data collected consisted of patient demographics, drug type, and number of drugs. Drug record discrepancies were classified and assigned a potential drug‐related problem. Results were compared with the electronic drug record. Patients with documented drug record discrepancies were compared with those patients for whom no discrepancy was identified.Results. Over the 5‐month period, 215 drug interviews were conducted in 63 patients. One hundred thirteen drug record discrepancies were identified in 38 patients (60%). Discrepancies (mean ± SD 1.7 ± 1.3, range 1–7) were identified during 65 drug interviews (30.2%). Electronic drug records were discrepant by one drug record, two drug records, and more than two drug records 60.0%, 26.2%, and 13.8% of the time, respectively. Drug record discrepancies placed patients at risk for adverse drug events and dosing errors in 49.6% and 34.5%, respectively, of 113 discrepancies. Patient age negatively correlated with the number of drug record discrepancies identified (r=−0.27, p=0.04).Conclusions. Drug record discrepancies occur frequently among patients undergoing hemodialysis. Incorporation of a pharmacist into the patient care team may increase the accuracy of the electronic drug record and avert unnecessary drug‐related problems.