Missing dosages and neuroleptic usage may prolong length of stay in hospitalized Parkinson's disease patients
Parkinson's disease patients are more likely to be hospitalized, have higher rates of hospital complications, and have an increased risk of deterioration during hospitalization. Length of stay is an important underlying factor for these increased risks. We aimed to investigate potential medicat...
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| creator | Martinez-Ramirez, Daniel Giugni, Juan C Little, Christopher S Chapman, John P Ahmed, Bilal Monari, Erin Wagle Shukla, Aparna Hess, Christopher W Okun, Michael S |
| description | Parkinson's disease patients are more likely to be hospitalized, have higher rates of hospital complications, and have an increased risk of deterioration during hospitalization. Length of stay is an important underlying factor for these increased risks. We aimed to investigate potential medication errors that may occur during hospitalization and its impact on length of hospital stay.
A cross-sectional chart review of 339 consecutive hospital encounters from 212 PD subjects was performed. Medication errors were defined as wrong timing or omission of administration for dopaminergic drugs and administration of contraindicated dopamine blockers. An analysis of covariance was applied to examine whether these medication errors were related to increased length of hospital stays.
A significant effect for dopaminergic administration (p |
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A cross-sectional chart review of 339 consecutive hospital encounters from 212 PD subjects was performed. Medication errors were defined as wrong timing or omission of administration for dopaminergic drugs and administration of contraindicated dopamine blockers. An analysis of covariance was applied to examine whether these medication errors were related to increased length of hospital stays.
A significant effect for dopaminergic administration (p<0.01) on length of hospital stay was observed. Subjects who had delayed administration or missed at least one dose stayed longer (M=8.2 days, SD=8.9 vs. M=3.6 days SD=3.4). Contraindicated dopamine blocking agents were administered in 23% (71/339) of cases, and this was also significantly related to an increased length of stay (M=8.2 days, SD=8.9 vs. M=3.6 days SD=3.4), p<0.05. Participants who received a contraindicated dopamine blocker stayed in the hospital longer (M=7.5 days, SD=9.1) compared to those who did not (M=5.9 days, SD=6.8). Neurologists were consulted in 24.5% of encounters. Specialty consultation had no effect on the medication related errors.
Missing dopaminergic dosages and administration of dopamine blockers occur frequently in hospitalized Parkinson's disease patients and this may impact length of stay. These potentially modifiable factors may reduce the risk of a longer stay related to hospitalization.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0124356</identifier><identifier>PMID: 25884484</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject><![CDATA[Accidental Falls - statistics & numerical data ; Aged ; Aged, 80 and over ; Analysis ; Antiparkinson Agents - administration & dosage ; Antipsychotic Agents - adverse effects ; Antipsychotic Agents - therapeutic use ; Comorbidity ; Complications ; Consultation ; Contraindications ; Covariance ; Cross-Sectional Studies ; Dementia ; Dopamine ; Dopamine Agents - administration & dosage ; Dopamine Antagonists - administration & dosage ; Dopamine Antagonists - adverse effects ; Dopamine receptors ; Drug administration ; Drug Administration Schedule ; Drugs ; Electronic Health Records ; Emergency medical care ; Family medical history ; Female ; Health care ; Health facilities ; Health maintenance organizations ; HMOs ; Hospitalization - statistics & numerical data ; Hospitals ; Humans ; Length of Stay - statistics & numerical data ; Male ; Martinez, Daniel ; Medical errors ; Medication Adherence ; Medication Errors ; Medicine ; Middle Aged ; Morbidity ; Mortality ; Movement disorders ; Neurodegenerative diseases ; Neurology ; Neurosurgery ; Older people ; Parkinson Disease - drug therapy ; Parkinson's disease ; Patients ; Population ; Ramirez, Michael ; Referral and Consultation - utilization ; Retrospective Studies ; Review boards ; Risk Factors ; Treatment Outcome]]></subject><ispartof>PloS one, 2015-04, Vol.10 (4), p.e0124356-e0124356</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Martinez-Ramirez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Martinez-Ramirez et al 2015 Martinez-Ramirez et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-b6a5b6cfa0fd26f62878d04cf581c2e6dba7b5a6987141959ec17534494db9703</citedby><cites>FETCH-LOGICAL-c692t-b6a5b6cfa0fd26f62878d04cf581c2e6dba7b5a6987141959ec17534494db9703</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4401689/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4401689/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25884484$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Martinez-Ramirez, Daniel</creatorcontrib><creatorcontrib>Giugni, Juan C</creatorcontrib><creatorcontrib>Little, Christopher S</creatorcontrib><creatorcontrib>Chapman, John P</creatorcontrib><creatorcontrib>Ahmed, Bilal</creatorcontrib><creatorcontrib>Monari, Erin</creatorcontrib><creatorcontrib>Wagle Shukla, Aparna</creatorcontrib><creatorcontrib>Hess, Christopher W</creatorcontrib><creatorcontrib>Okun, Michael S</creatorcontrib><title>Missing dosages and neuroleptic usage may prolong length of stay in hospitalized Parkinson's disease patients</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Parkinson's disease patients are more likely to be hospitalized, have higher rates of hospital complications, and have an increased risk of deterioration during hospitalization. Length of stay is an important underlying factor for these increased risks. We aimed to investigate potential medication errors that may occur during hospitalization and its impact on length of hospital stay.
A cross-sectional chart review of 339 consecutive hospital encounters from 212 PD subjects was performed. Medication errors were defined as wrong timing or omission of administration for dopaminergic drugs and administration of contraindicated dopamine blockers. An analysis of covariance was applied to examine whether these medication errors were related to increased length of hospital stays.
A significant effect for dopaminergic administration (p<0.01) on length of hospital stay was observed. Subjects who had delayed administration or missed at least one dose stayed longer (M=8.2 days, SD=8.9 vs. M=3.6 days SD=3.4). Contraindicated dopamine blocking agents were administered in 23% (71/339) of cases, and this was also significantly related to an increased length of stay (M=8.2 days, SD=8.9 vs. M=3.6 days SD=3.4), p<0.05. Participants who received a contraindicated dopamine blocker stayed in the hospital longer (M=7.5 days, SD=9.1) compared to those who did not (M=5.9 days, SD=6.8). Neurologists were consulted in 24.5% of encounters. Specialty consultation had no effect on the medication related errors.
Missing dopaminergic dosages and administration of dopamine blockers occur frequently in hospitalized Parkinson's disease patients and this may impact length of stay. These potentially modifiable factors may reduce the risk of a longer stay related to hospitalization.</description><subject>Accidental Falls - statistics & numerical data</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis</subject><subject>Antiparkinson Agents - administration & dosage</subject><subject>Antipsychotic Agents - adverse effects</subject><subject>Antipsychotic Agents - therapeutic use</subject><subject>Comorbidity</subject><subject>Complications</subject><subject>Consultation</subject><subject>Contraindications</subject><subject>Covariance</subject><subject>Cross-Sectional Studies</subject><subject>Dementia</subject><subject>Dopamine</subject><subject>Dopamine Agents - administration & dosage</subject><subject>Dopamine Antagonists - administration & dosage</subject><subject>Dopamine Antagonists - adverse effects</subject><subject>Dopamine receptors</subject><subject>Drug administration</subject><subject>Drug Administration Schedule</subject><subject>Drugs</subject><subject>Electronic Health Records</subject><subject>Emergency medical care</subject><subject>Family medical history</subject><subject>Female</subject><subject>Health care</subject><subject>Health facilities</subject><subject>Health maintenance organizations</subject><subject>HMOs</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Martinez, Daniel</subject><subject>Medical errors</subject><subject>Medication Adherence</subject><subject>Medication Errors</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Movement disorders</subject><subject>Neurodegenerative diseases</subject><subject>Neurology</subject><subject>Neurosurgery</subject><subject>Older people</subject><subject>Parkinson Disease - drug therapy</subject><subject>Parkinson's disease</subject><subject>Patients</subject><subject>Population</subject><subject>Ramirez, Michael</subject><subject>Referral and Consultation - utilization</subject><subject>Retrospective Studies</subject><subject>Review boards</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk8tu1DAUhiMEomXgDRBYQuKymMH3JBukquIyUlERt63l2E7GxbFD7CDK0-PppNUM6gJ5Yev3d377HPsUxWMEV4iU6PVFmEYv3WoI3qwgwpQwfqc4RjXBS44hubu3PioexHgBISMV5_eLI8yqitKKHhf9Rxuj9R3QIcrORCC9Bt5MY3BmSFaBaSuDXl6CIWshk874Lm1AaEFMWbYebEIcbJLO_jEafJLjD-tj8C8i0DYaGQ0YZLLGp_iwuNdKF82jeV4U3969_Xr6YXl2_n59enK2VLzGadlwyRquWglbjXnLcVVWGlLVsgopbLhuZNkwyeuqRBTVrDYKlYxQWlPd1CUki-LpzndwIYq5UlEgXpKaUVSWmVjvCB3khRhG28vxUgRpxZUQxk7IMefvjGC8MS3TpFGY0VIqqSg1LYUQEkM5brLXm_m0qemNVjnTUboD08MdbzeiC78EpRDxqs4GL2eDMfycTEyit1EZ56Q3Ybq6N80cRlv02T_o7dnNVCdzAta3IZ-rtqbihGJGeAVzvRbF6hYqD216q_K3am3WDwJeHQRkJpnfqZNTjGL95fP_s-ffD9nne-zGSJc2Mbgp2eDjIUh3oBpDjKNpb4qMoNh2xXU1xLYrxNwVOezJ_gPdBF23AfkLvvMIyQ</recordid><startdate>20150417</startdate><enddate>20150417</enddate><creator>Martinez-Ramirez, Daniel</creator><creator>Giugni, Juan C</creator><creator>Little, Christopher S</creator><creator>Chapman, John P</creator><creator>Ahmed, Bilal</creator><creator>Monari, Erin</creator><creator>Wagle Shukla, Aparna</creator><creator>Hess, Christopher W</creator><creator>Okun, Michael S</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20150417</creationdate><title>Missing dosages and neuroleptic usage may prolong length of stay in hospitalized Parkinson's disease patients</title><author>Martinez-Ramirez, Daniel ; Giugni, Juan C ; Little, Christopher S ; Chapman, John P ; Ahmed, Bilal ; Monari, Erin ; Wagle Shukla, Aparna ; Hess, Christopher W ; Okun, Michael S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-b6a5b6cfa0fd26f62878d04cf581c2e6dba7b5a6987141959ec17534494db9703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Accidental Falls - statistics & numerical data</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis</topic><topic>Antiparkinson Agents - administration & dosage</topic><topic>Antipsychotic Agents - adverse effects</topic><topic>Antipsychotic Agents - therapeutic use</topic><topic>Comorbidity</topic><topic>Complications</topic><topic>Consultation</topic><topic>Contraindications</topic><topic>Covariance</topic><topic>Cross-Sectional Studies</topic><topic>Dementia</topic><topic>Dopamine</topic><topic>Dopamine Agents - administration & dosage</topic><topic>Dopamine Antagonists - administration & dosage</topic><topic>Dopamine Antagonists - adverse effects</topic><topic>Dopamine receptors</topic><topic>Drug administration</topic><topic>Drug Administration Schedule</topic><topic>Drugs</topic><topic>Electronic Health Records</topic><topic>Emergency medical care</topic><topic>Family medical history</topic><topic>Female</topic><topic>Health care</topic><topic>Health facilities</topic><topic>Health maintenance organizations</topic><topic>HMOs</topic><topic>Hospitalization - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Martinez-Ramirez, Daniel</au><au>Giugni, Juan C</au><au>Little, Christopher S</au><au>Chapman, John P</au><au>Ahmed, Bilal</au><au>Monari, Erin</au><au>Wagle Shukla, Aparna</au><au>Hess, Christopher W</au><au>Okun, Michael S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Missing dosages and neuroleptic usage may prolong length of stay in hospitalized Parkinson's disease patients</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-04-17</date><risdate>2015</risdate><volume>10</volume><issue>4</issue><spage>e0124356</spage><epage>e0124356</epage><pages>e0124356-e0124356</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Parkinson's disease patients are more likely to be hospitalized, have higher rates of hospital complications, and have an increased risk of deterioration during hospitalization. Length of stay is an important underlying factor for these increased risks. We aimed to investigate potential medication errors that may occur during hospitalization and its impact on length of hospital stay.
A cross-sectional chart review of 339 consecutive hospital encounters from 212 PD subjects was performed. Medication errors were defined as wrong timing or omission of administration for dopaminergic drugs and administration of contraindicated dopamine blockers. An analysis of covariance was applied to examine whether these medication errors were related to increased length of hospital stays.
A significant effect for dopaminergic administration (p<0.01) on length of hospital stay was observed. Subjects who had delayed administration or missed at least one dose stayed longer (M=8.2 days, SD=8.9 vs. M=3.6 days SD=3.4). Contraindicated dopamine blocking agents were administered in 23% (71/339) of cases, and this was also significantly related to an increased length of stay (M=8.2 days, SD=8.9 vs. M=3.6 days SD=3.4), p<0.05. Participants who received a contraindicated dopamine blocker stayed in the hospital longer (M=7.5 days, SD=9.1) compared to those who did not (M=5.9 days, SD=6.8). Neurologists were consulted in 24.5% of encounters. Specialty consultation had no effect on the medication related errors.
Missing dopaminergic dosages and administration of dopamine blockers occur frequently in hospitalized Parkinson's disease patients and this may impact length of stay. These potentially modifiable factors may reduce the risk of a longer stay related to hospitalization.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>25884484</pmid><doi>10.1371/journal.pone.0124356</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2015-04, Vol.10 (4), p.e0124356-e0124356 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1673954177 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Accidental Falls - statistics & numerical data Aged Aged, 80 and over Analysis Antiparkinson Agents - administration & dosage Antipsychotic Agents - adverse effects Antipsychotic Agents - therapeutic use Comorbidity Complications Consultation Contraindications Covariance Cross-Sectional Studies Dementia Dopamine Dopamine Agents - administration & dosage Dopamine Antagonists - administration & dosage Dopamine Antagonists - adverse effects Dopamine receptors Drug administration Drug Administration Schedule Drugs Electronic Health Records Emergency medical care Family medical history Female Health care Health facilities Health maintenance organizations HMOs Hospitalization - statistics & numerical data Hospitals Humans Length of Stay - statistics & numerical data Male Martinez, Daniel Medical errors Medication Adherence Medication Errors Medicine Middle Aged Morbidity Mortality Movement disorders Neurodegenerative diseases Neurology Neurosurgery Older people Parkinson Disease - drug therapy Parkinson's disease Patients Population Ramirez, Michael Referral and Consultation - utilization Retrospective Studies Review boards Risk Factors Treatment Outcome |
| title | Missing dosages and neuroleptic usage may prolong length of stay in hospitalized Parkinson's disease patients |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-06T16%3A55%3A17IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Missing%20dosages%20and%20neuroleptic%20usage%20may%20prolong%20length%20of%20stay%20in%20hospitalized%20Parkinson's%20disease%20patients&rft.jtitle=PloS%20one&rft.au=Martinez-Ramirez,%20Daniel&rft.date=2015-04-17&rft.volume=10&rft.issue=4&rft.spage=e0124356&rft.epage=e0124356&rft.pages=e0124356-e0124356&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0124356&rft_dat=%3Cgale_plos_%3EA425368075%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1673954177&rft_id=info:pmid/25884484&rft_galeid=A425368075&rft_doaj_id=oai_doaj_org_article_56bef5d3bc2547acac44ef40003e462b&rfr_iscdi=true |