Abstract
Purpose :
Discrepancies between prescribed outpatient and inpatient medications are known to occur. These errors have not been characterized in topical glaucoma medications. This study aims to describe the frequency of topical glaucoma medication discrepancies and to determine if factors such as number of glaucoma medications, demographic factors, and admitting service confer greater odds of a medication discrepancy.
Methods :
This is a retrospective cohort study of a random sample of adult patients with primary open angle glaucoma on at least one topical glaucoma medication admitted to any Cleveland Clinic facility between January 1, 2012 to January 1, 2023. All patients were required to have a at least one visit to a Cole Eye Institute ophthalmologist within 12 months prior to admission. Chart review was done to collect demographics, hospital site, discrepant medications, provider degree, admitting service, and pharmacy consultation. Inpatient reconciliation at admission, transfer, and discharge was compared against the outpatient ophthalmic record for discrepant prescriptions. Logistic and ordinal regression was used to appreciate factors associated with odds of error.
Results :
After screening 1,756 charts, 970 encounters were analyzed. Discrepancies were noted in 278 of 970 (28.6%) encounters. Patient demographics, hospital site, provider type, admitting service, and pharmacy consultation did not alter the odds of error. The rate of discrepancies was highest in patients on three medications (41.2%) followed by one medication (29.3%) and then two medications (26.8%) (P<0.001). On regression analysis, there was no correlation between the number of glaucoma medications and frequency of discrepancies. Medication discrepancy in previous hospitalization increased odds of discrepancy in subsequent admission (OR 5.1, 95% CI [3.2-8.4], P<0.001). A discrepancy on admission significantly increased error rates at transfer and discharge (P<0.001).
Conclusions :
Glaucoma medications are often associated preventable discrepancies that may propagate through an admission and from prior admissions. Future studies are needed to better understand, and ideally, prevent, the factors associated with these errors.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.