Clinical outcomes from the use of Medication Report when elderly patients are discharged from hospital

Midlöv, Patrik; Deierborg, Eva; Holmdahl, Lydia; Höglund, Peter; Eriksson, Tommy

doi:10.1007/s11096-008-9236-1

Cited by 35 publications

(46 citation statements)

References 22 publications

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“…However in the latter study, we did not evaluate the quality of the discharge summary, and the errors were measured at discharge based on the discharge summary and not when patients returned to primary care as was the case in this study. The latter study also showed a reduction in clinical consequences based on medication errors [20]. In our previous descriptive study, there were an average of 2.4 medication errors per patient at admission to the hospital, and only 15% of the patients had no errors at all [18].…”

Section: Discussionmentioning

confidence: 64%

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Improved quality in the hospital discharge summary reduces medication errors—LIMM: Landskrona Integrated Medicines Management

Bergkvist

Midlöv

Höglund

et al. 2009

Eur J Clin Pharmacol

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106

114

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Purpose We have developed a model for integrated medicines management, including tools and activities for medication reconciliation and medication review. In this study, we focus on improving the quality of the discharge summary including the medication report to reduce medication errors in the transition from hospital to primary and community care. Methods This study is a longitudinal study with an intervention group and a control group. The intervention group comprised 52 patients, who were included from 1 March 2006 until 31 December 2006, with a break during summer. Inclusion in the control group was performed in the same wards during the period 1 September 2005 until 20 December 2005, and 63 patients were included in the control group. In order to improve the quality of the medication report, clinical pharmacists reviewed and gave feedback to the physician on the discharge summary before patient discharge, using a structured checklist. Medication errors were then identified by comparing the medication list in the discharge summary with the first medication list used in the community health care after the patient had returned home.Results By improving the quality of the discharge summary, patients had on average 45% fewer medication errors per patient (P=0.012). The proportion of patients without medication errors was 63.5% in the control group and 73.1% in the intervention group. However, this increase was not significant (P=0.319). Patients who used a specific medication dispensing system (ApoDos) had a 5.9-fold higher risk of suffering from medication errors than those without this medication dispensing system (P<0.001). Conclusion Review and feedback on errors in the discharge summary, including the medication report and a correct medication list, reduced medication errors during the transfer of information from hospital to primary and community care.Keywords Elderly . Hospital discharge . Inpatients . Medication errors . Medication reconciliation . Medication report IntroductionIn the elderly, the risk of medication errors increases with the number of home medications when admitted to or discharged from hospital [1]. Medication errors can lead to Eur J Clin Pharmacol (2009) severe consequences for the patient, and 20-30% of medication errors have been assessed as potential adverse drug events [2]. A review article reports that of the medication errors identified, 11-59% were thought to be of clinical importance [3]. Various types of medication errors are frequent in hospitals [4,5] and in the interface between care levels [6][7][8][9][10][11][12][13][14][15][16]. Insufficient quality in the transfer of information on a patient's medications has recently been highlighted as one of the most important problems in health care, and international and national programs have been developed for information and help [16]. According to the Institute for Healthcare Improvement, poor communication of medical information at transition points is responsible for as many as 50% of all medication errors and 20...

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Section: Discussionmentioning

confidence: 64%

“…The medication report has also been shown to significantly reduce morbidity and thus the need for medical care due to medication errors in the elderly [20]. However, the study did not evaluate the content and correctness of the medication report, so there is room for further improvement in the process, which is the basis for this study.…”

Section: Introductionmentioning

confidence: 99%

Improved quality in the hospital discharge summary reduces medication errors—LIMM: Landskrona Integrated Medicines Management

Bergkvist

Midlöv

Höglund

et al. 2009

Eur J Clin Pharmacol

Self Cite

106

114

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“…Medication errors are, however, also frequent at the interface between levels of care [31][32][33]. In order to minimise this problem, we have also developed and evaluated separate methods for use at admission to [34] and discharge from [35][36][37] hospital. These studies contribute to the evidence of the usefulness of the entire in-hospital patient care process model, the LIMM model, which comprises a model of care from admission, through the hospital stay to discharge and transferral of the patient back to primary or community care.…”

Section: Discussionmentioning

confidence: 99%

In-hospital medication reviews reduce unidentified drug-related problems

Bondesson

Eriksson

Kragh

et al. 2012

Eur J Clin Pharmacol

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“…In addition, the individual LIMM-tools have been shown to reduce unidentified DRPs during the patients" hospital stay (20) and reduce the need for health care contacts caused by medication errors (21). These findings describe outcomes for the patient, but we were also interested in how the model is appreciated by the health care personnel and how it affects the daily work regarding DRPs.…”

Section: The Process Of Identifying Solving and Preventing Drug Relamentioning

confidence: 99%

The process of identifying, solving and preventing drug related problems in the LIMM-study

et al. 2011

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Objective To avoid negative effects of drug treatment and need for additional medical care, drug treatment must be individualised. Our research group has developed a model for clinical pharmacy which improves several aspects of the patient's drug treatment. This study describes the process behind these improvements, i.e. drug related problems identified by pharmacists within a clinical pharmacy service.Setting Three wards at a department of internal medicine.Method Pharmacists performed systematic interventions during the patient's hospital stay, aiming to identify, solve and prevent drug related problems in the elderly. Identified drug related problems were put forward to the health care team and discussed. Information on identified problems, and their outcomes was collected and analysed. A questionnaire was used to evaluate the health care personnel's attitudes towards the process. Main outcome measureThe number of drug related problems identified by the clinical pharmacists, the proportion of problems discussed with the physicians, the proportion of problems adjusted by the physicians and whether pharmacists and physicians prioritised any subgroup of drug related problems when choosing which problems to address. Finally, we wanted to evaluate the health care personnel's attitudes towards the model. ResultsIn total, 1227 problem were identified in 190 patients. The pharmacists discussed 685 (55.8%) of the identified problems with the physicians who accepted 438 (63.9%) of the suggestions. There was no significant difference in which subgroup to put forward and which to adjust. There was a high response rate (84%) to the questionnaire, and the health care personnel estimated the benefits to be very high, both for the patients and for themselves. ConclusionThe process for identifying, solving and preventing drug related problems was good and the different types of problems were considered equally important. The addition of a clinical pharmacy service was considered very useful. This suggests that the addition of our clinical pharmacy service to the hospital setting add skills of great importance. KeywordsClinical pharmacy service, Drug related problem (DRP), elderly, inpatients, LIMM-study,

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Clinical outcomes from the use of Medication Report when elderly patients are discharged from hospital

Abstract: The Medication Report seems to be an effective tool to decrease adverse clinical consequences when elderly patients are discharged from hospital care.

Cited by 35 publications

References 22 publications

Improved quality in the hospital discharge summary reduces medication errors—LIMM: Landskrona Integrated Medicines Management

Improved quality in the hospital discharge summary reduces medication errors—LIMM: Landskrona Integrated Medicines Management

In-hospital medication reviews reduce unidentified drug-related problems

The process of identifying, solving and preventing drug related problems in the LIMM-study

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