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1 Romero R, Athayde N, Maymon E, Pacora P, Bahado-Singh R. Premature rupture of the membranes. In: Reece A, Hobbins J, eds. Medicine of the fetus and mother. Philadelphia: Lippincott-Raven, 1999: 1581625. McLaren J, Malak TM, Bell SC. Structural characteristics of term human fetal membranes prior to labour: identification of an area of altered morphology overlying the cervix. Hum Reprod 1999; 14: 23741.
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Patients were older mean age, 77 years ; and women 58.9% ; , and they were admitted with different medical conditions. We completed medication use interviews with all 151 participants. Of these, 109 72.2% ; had medication vials available for inspection. For the remaining patients, medications were verified with the community pharmacy 26 patients ; or from a written list of medications used at home 16 patients ; . Eighty-one patients 53.6%; 95% confidence interval, 45.7%-61.6% ; had at least 1 unintended discrepancy. We identified 140 unintended discrepancies among these 81 patients. The overall rate of unintended discrepancies was 0.93 per patient. The most common error 46.4% ; was omission of a regularly used medication. Other types of errors are summarized in Table 2. Most discrepancies were associated with cardiovascular drugs 26.6% ; and central nervous system drugs 25.9% ; . There was fair interrater reliability for judging the potential severity of discrepancies 0.26, 95% confidence interval, 0.16-0.36 ; .8 Consensus was easily achieved in areas of disagreement. Most 61.4% ; of the discrepancies were deemed unlikely to cause harm class 1 ; . However, 32.9% of the discrepancies were judged to have the potential to cause moderate discomfort or clinical deterioration class 2 ; , and 5.7% were judged to have the potential to cause severe discomfort or clinical deterioration class 3 ; Table 2 ; . The details of the discrepancies that were assigned a class 3 potential severity rating are summarized in Table 3. Some examples include the following: 2 patients who continued taking their own nonsteroidal anti-inflammatory drug, without the admitting physician's knowledge, after being hospitalized for a gastrointestinal hemorrhage; 1 patient whose predni REPRINTED ; ARCH INTERN MED VOL 165, FEB 28, 2005 426.
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