| Sub-title | |
| Authors | L M West M Cordina B Caruana Montaldo J M Cacciottolo S Cunningham |
| Abstract | Background: Appropriate prescribing remains an important priority in all medical areas of practice. Medication appropriateness can be defined as the outcome of a process of decision-making that maximises net individual health gains within society's available resources. Objective: To apply a Medication Appropriateness Index (MAI) to identify issues of inappropriate prescribing amongst patients admitted from the Emergency Department (ED). Method: This study was carried out at St Luke's Hospital on 125 patients following a two-week pilot period on 10 patients. Patients aged 18 years and over and on drug therapy were included. Patients who were not reviewed prior to the post-take ward round and direct admissions were excluded. Drug treatment for inappropriateness was assessed by using a MAI, which was tested for content validity and reliability. Results: Treatment charts of 125 patients, including 697 drugs, were assessed using a MAI. Overall, 115 (92%) patients had ≥1 medications with ≥1 MAI criteria rated as inappropriate, giving a total of 384 (55.1%) drugs prescribed inappropriately. The mean ± SD MAI score per drug was 1.78 ± 2.19. The most common drug classes with appropriateness problems were supplements (20.1%) and antibiotics (20.0%). The most common problems involved incorrect directions (26%) and incorrect dosages (18.5%). There were 36 omitted drugs with untreated indications. Conclusion: Considerable inappropriate prescribing was identified, which could have significant negative effects on patient care. |
Published in: | |
| Journal | Malta Medical Journal |
| Volume | 18 Supplement |
| Page | |
| Date | 01/12/2006 |
| Link to journal | |
| Key words | accident and emergency, inappropriate prescribing, medical admissions, medication appropriateness index |