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Original Article
Online Published: 20 Jan 2026
 


Clinical consequences of medication discrepancies during ICU transitions of care at a tertiary hospital in Saudi Arabia

Fahad Alzahrani, Sara E. Ibrahim, Mohammed Hashim Albashir, Marwah Faraj Alahmadi, Mawaddah Aljohani, Layan Mohammed Alhusini, Mona Thamer Alharbi, Ameer Khalid Saab.


Abstract
Objective: This study aimed to evaluate the influence of medication discrepancies (MDs) at intensive care unit (ICU) discharge on some key short-term post-ICU outcomes.
Methods: A retrospective cohort study was conducted using real-world ICU data, i.e., demographics, comorbidities, mechanical ventilation status, pre-admission medications, sources of medication history, discrepancies at admission and discharge, and risk factors such as polypharmacy and emergency admission. The MDs were classified into no indication for therapy, drug omission, therapeutic duplication, incorrect dose, inappropriate route, and inappropriate duration.
Results: MDs were identified in many patients, with drug omission and no indication for therapy being the most frequent. Patients with ≥ 2 discrepancies at ICU discharge had significantly longer post-ICU hospital stays than those without discrepancies (mean difference: +2.8 days; p < 0.01). High-risk discrepancy patterns, such as drug omission and incorrect dosing, were independently associated with early clinical deterioration within 72 hours of ICU transfer (adjusted OR: 2.31; 95% CI: 1.14–4.49). These negative effects were exacerbated by polypharmacy.
Conclusion: MDs at ICU discharge were significant determinants of early post-ICU clinical trajectories, which resulted in longer hospital stays and higher rates of early deterioration. Thus, strengthening of pharmacist-led medication reconciliation at critical transition points might mitigate preventable adverse outcomes and improve continuity of care for critically ill patients.

Key words: Medication discrepancies, ICU care, transitions, consequences, Saudi Arabia.


 
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How to Cite this Article
Pubmed Style

Alzahrani F, Ibrahim SE, Albashir MH, Alahmadi MF, Aljohani M, Alhusini LM, Alharbi MT, Saab AK. Clinical consequences of medication discrepancies during ICU transitions of care at a tertiary hospital in Saudi Arabia. IJMDC. 2026; 10(1): 262-267. doi:10.24911/IJMDC.51-1766747402

Web Style

Alzahrani F, Ibrahim SE, Albashir MH, Alahmadi MF, Aljohani M, Alhusini LM, Alharbi MT, Saab AK. Clinical consequences of medication discrepancies during ICU transitions of care at a tertiary hospital in Saudi Arabia. https://www.ijmdc.com/?mno=304547 [Access: January 25, 2026]. doi:10.24911/IJMDC.51-1766747402

AMA (American Medical Association) Style

Alzahrani F, Ibrahim SE, Albashir MH, Alahmadi MF, Aljohani M, Alhusini LM, Alharbi MT, Saab AK. Clinical consequences of medication discrepancies during ICU transitions of care at a tertiary hospital in Saudi Arabia. IJMDC. 2026; 10(1): 262-267. doi:10.24911/IJMDC.51-1766747402


Vancouver/ICMJE Style

Alzahrani F, Ibrahim SE, Albashir MH, Alahmadi MF, Aljohani M, Alhusini LM, Alharbi MT, Saab AK. Clinical consequences of medication discrepancies during ICU transitions of care at a tertiary hospital in Saudi Arabia. IJMDC. (2026), [cited January 25, 2026]; 10(1): 262-267. doi:10.24911/IJMDC.51-1766747402


Harvard Style

Alzahrani, F., Ibrahim, . S. E., Albashir, . M. H., Alahmadi, . M. F., Aljohani, . M., Alhusini, . L. M., Alharbi, . M. T. & Saab, . A. K. (2026) Clinical consequences of medication discrepancies during ICU transitions of care at a tertiary hospital in Saudi Arabia. IJMDC, 10 (1), 262-267. doi:10.24911/IJMDC.51-1766747402


Turabian Style

Alzahrani, Fahad, Sara E. Ibrahim, Mohammed Hashim Albashir, Marwah Faraj Alahmadi, Mawaddah Aljohani, Layan Mohammed Alhusini, Mona Thamer Alharbi, and Ameer Khalid Saab. 2026. Clinical consequences of medication discrepancies during ICU transitions of care at a tertiary hospital in Saudi Arabia. International Journal of Medicine in Developing Countries, 10 (1), 262-267. doi:10.24911/IJMDC.51-1766747402


Chicago Style

Alzahrani, Fahad, Sara E. Ibrahim, Mohammed Hashim Albashir, Marwah Faraj Alahmadi, Mawaddah Aljohani, Layan Mohammed Alhusini, Mona Thamer Alharbi, and Ameer Khalid Saab. "Clinical consequences of medication discrepancies during ICU transitions of care at a tertiary hospital in Saudi Arabia." International Journal of Medicine in Developing Countries 10 (2026), 262-267. doi:10.24911/IJMDC.51-1766747402


MLA (The Modern Language Association) Style

Alzahrani, Fahad, Sara E. Ibrahim, Mohammed Hashim Albashir, Marwah Faraj Alahmadi, Mawaddah Aljohani, Layan Mohammed Alhusini, Mona Thamer Alharbi, and Ameer Khalid Saab. "Clinical consequences of medication discrepancies during ICU transitions of care at a tertiary hospital in Saudi Arabia." International Journal of Medicine in Developing Countries 10.1 (2026), 262-267. Print. doi:10.24911/IJMDC.51-1766747402


APA (American Psychological Association) Style

Alzahrani, F., Ibrahim, . S. E., Albashir, . M. H., Alahmadi, . M. F., Aljohani, . M., Alhusini, . L. M., Alharbi, . M. T. & Saab, . A. K. (2026) Clinical consequences of medication discrepancies during ICU transitions of care at a tertiary hospital in Saudi Arabia. International Journal of Medicine in Developing Countries, 10 (1), 262-267. doi:10.24911/IJMDC.51-1766747402




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