The specific aims of this study were to (1) identify gaps in recommended laboratory monitoring at initiation of therapy (2) describe variations in baseline laboratory monitoring by age, sex, number of chronic diseases, drug, and health plan and (3) assess the utility of automated data in identifying lack of laboratory monitoring. We undertook the current study to assess laboratory monitoring for organ injury, organ dysfunction, and electrolyte abnormalities requiring correction among patients initiating medications for which product labeling or other guideline recommends monitoring.

21 – 29īetter understanding of patterns of laboratory monitoring associated with drug therapy will inform patient safety interventions and potentially affect therapy costs and decrease complications. 19 – 21 The few published studies evaluating adherence to laboratory monitoring recommendations document that monitoring recommendations are not followed for 27% to 91% of patients. 17, 18 The importance of laboratory monitoring for drugs such as divalproex, isotretinoin, ketoconazole, lithium, metformin, rifampin, carbamazepine, and allopurinol is reflected in product labeling and published guidelines. Laboratory monitoring errors occur when there is failure to conduct indicated laboratory tests, when there is avoidable delay in responding to abnormal tests, or when there is inadequate follow-up. One subset of medication use errors is related to laboratory monitoring for drugs that carry a risk of organ system toxicity or that require dosage adjustment in the presence of organ dysfunction. However, medication use errors in the ambulatory care environment can be errors of omission, commission, or prevention and carry risks amplified in importance by the numbers of patients receiving treatment. 1, 2 Most attention to medication use errors has been in hospitalized patients.

Errors of medication use are common and occur throughout the drug use continuum.

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