Ireland has a ‘very fragmented healthcare system', which increases the risk of medication errors, researchers have warned.
According to the researchers, while there is no national data on the incidence of medication errors in the Irish healthcare system, recent studies carried out in Irish hospitals identified such errors in ‘up to half of acute medical or surgical patients'.
Types of errors can include being prescribed the wrong medication, being prescribed the wrong dose or the omission of a medication that is still required. People at particular risk include older patients and those who require more than one type of medication.
The researchers found that because Ireland's healthcare system is so fragmented, errors are possible as patients move through the system from one level of care or location to the next - known as the care transition.
"Movement between different levels of care - the community, hospital, and long-term care/nursing homes - creates opportunities for error. Furthermore, movement within these facilities - admission, transfer and discharge - yet again presents the opportunity for discrepancies to occur," they noted.
They highlighted the fact that while these errors can pose a risk to patients at any stage of treatment, if they occur at the beginning of care, ‘they are likely to perpetuate in a cascade throughout the patient's treatment and through transitions of care'. This can often lead to more GP and Emergency Department (ED) visits.
The researchers said that there is a need for better medicine reconciliation processes. Medicine reconciliation is defined as the ‘process of obtaining and maintaining a complete and accurate list of the current medication use of a patient across healthcare settings'.
This aims to prevent medication errors that occur during care transitions, such as by verifying the patient's medication list from their previous centre of care, checking that this is the most current list and documenting any discrepancies.
Currently in Ireland, nobody has responsibility for keeping track of medications and in many cases, doctors ‘rely on the patients themselves to notify them of medication changes' that they may have undergone while under other care.
The researchers concluded that ‘there is a need for better medicine reconciliation processes in both primary care, hospital-based care and long-term care facilities'.
The researchers from the Royal College of Surgeons, the Health Research Board and Trinity College Dublin made their comments in Forum, the Journal of the Irish College of General Practitioners.