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March 8, 2000

Preventing Medication Errors in the Intensive Care Unit

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(10):1287-1289. doi:10.1001/jama.283.10.1287

To the Editor: Dr Leape and colleagues1 have demonstrated that the inclusion of a pharmacist on medical rounds significantly reduces clinical morbidity and economic costs resulting from preventable adverse drug events (ADEs). However, we believe that a few points deserve comment. In the study group, 45% of the interventions made by a pharmacist participating in rounds involved clarification or correction of an order. In the control group, pharmacists not participating in rounds also had a presence, but it is unclear if they were allowed to make interventions, such as retrospective clarification or correction of drug orders. In many practice settings, such retrospective intervention frequently corrects errors before medications are dispensed or administered to patients. If interventions of any type were done by the pharmacist not participating in rounds, reporting of this behavior would be valuable for assessing differences in intervention patterns between the 2 groups and identifying the types of interventions that play a greater role in reducing the rate of ADEs. Additionally, as clinical experience and expertise can influence a pharmacist's ability to detect potential ADEs, it would be beneficial to know if the study and control pharmacists had comparable experience and training.

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