Unintentional medication discrepancy results in adverse drug events in cancer patients

Patients undergoing cancer surgery who experience unintentional medication discrepancies are susceptible to postoperative adverse drug events (ADEs), reports a study.

Five hundred patients with a total of 7,254 medication orders were followed from surgery to day 30 postoperatively. Of the orders, 905 (12.5 percent) resulted in unintentional medication discrepancies.

Polypharmacy (odds ratio [OR], 1.32, 95 percent confidence interval [CI], 1.21‒1.44; p<0.001) and length of stay (OR, 1.07, 95 percent CI, 1.03‒1.12; p=0.001) were significantly associated with unintentional medication discrepancies. Moreover, 82 patients (16.4 percent) experienced ADEs.

ADEs were higher among patients who had unintentional vs intentional discrepancies (OR, 3.06, 95 percent CI, 1.66‒5.64; p<0.001), older age (OR, 1.05, 95 percent CI, 1.02‒1.08; p<0.001), polypharmacy (OR, 1.20, 95 percent CI, 1.08‒1.33; p<0.001), higher acuity care admission (OR, 2.46, 95 percent CI, 1.33‒4.54; p=0.004), and prolonged hospital length of stay (OR, 1.07, 95 percent CI, 1.01‒1.12; p=0.002).

Notably, the agents that contributed most frequently to both discrepancies and ADEs were cardiovascular and alimentary tract medications.

“Targeted strategies—especially for older patients, those with polypharmacy, and extended hospital stays—are essential to enhance medication safety across perioperative transitions,” the authors said.

This study involved adult patients undergoing planned major cancer surgery at a Melbourne specialist cancer hospital. The authors assessed regular medication discrepancies across transitions of care up to 5 days after surgery and at discharge. They also monitored ADEs up to 30 days postoperatively. Multivariable logistic regression was used to identify predictors of ADEs and medication discrepancies.