Patient-, medication- and environment-related factors affecting medication discrepancies in older patients

Manias, Elizabeth; Annakis, Noel; Considine, Julie; Weerasuriya, Rona; Kusljic, Snezana

doi:10.1016/j.colegn.2016.10.012

Cited by 4 publications

(3 citation statements)

References 18 publications

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“…Problems with unintended medication discrepancies that occur when patients transfer between different care levels or therapists are widely reported, however these are claimed to have little clinical significance [33]. Others [34] show that medication discrepancies increase the risk of hospital admissions and that older patients who lack social supports may be particularly vulnerable (e.g. older patients living alone).…”

Section: Discussionmentioning

confidence: 99%

Variations in drug-related problems detected by multidisciplinary teams in Norwegian nursing homes and home nursing care

Devik

Olsen

Fiskvik³

et al. 2018

Scandinavian Journal of Primary Health Care

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The frequency of unclear documentation and adverse reactions found in the homecare setting is alarming. This is an important issue given the trend in aged care towards caring people in their own homes. Further research is warranted to explore how different care settings may influence the safety of pharmacotherapy for older persons. Key Points Drug related problems are a significant cause of concern among patients receiving home nursing care as well as for patients living in nursing homes. The findings of this study showed that: •Significantly more DRPs were detected among patients receiving home nursing care than patients living in nursing homes. •While patients living in nursing homes were often undermedicated, documentation discrepancies were more frequent in home nursing care. •DRP categories leading to changes on the medication lists differed between the settings.

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Section: Discussionmentioning

confidence: 99%

Variations in drug-related problems detected by multidisciplinary teams in Norwegian nursing homes and home nursing care

Devik

Olsen

Fiskvik³

et al. 2018

Scandinavian Journal of Primary Health Care

View full text Add to dashboard Cite

show abstract

“…Public or internal reporting may trigger investigation into various reasons for discrepancies in the reporting and administration of medication for older persons, including: the number of medications a person is on, social support from family members and/or a focus on physical assessments without an integrated evaluation of medications in acute care settings. 37 Safety measure results in this study also highlight insufficient reporting back to the LTC facility, particularly related to ED summaries not being provided to LTC facilities on discharge from the ED. Hospital-based reporting of such quality metrics could be used to improve care in the future.…”

Section: Discussionmentioning

confidence: 82%

“…Internal or public reporting of this indicator across all involved care settings can support efforts to ensure this quality measure is met. Public or internal reporting may trigger investigation into various reasons for discrepancies in the reporting and administration of medication for older persons, including: the number of medications a person is on, social support from family members and/or a focus on physical assessments without an integrated evaluation of medications in acute care settings 37…”

Section: Discussionmentioning

confidence: 99%

Assessing quality of older persons’ emergency transitions between long-term and acute care settings: a proof-of-concept study

et al. 2022

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BackgroundLong-term care (LTC) residents frequently experience transitions in the location of more advanced care delivery, including receiving emergency department (ED) care. In this proof-of-concept study, we aimed to determine if we could identify measures in quality of care across transitions from LTC to the ED, via emergency medical services and back, by applying Institute of Medicine (IOM) Quality of Care Domains to an existing dataset.MethodsIn the Older Persons’ Transitions in Care (OPTIC) study, we collected information on residents’ transitions in two Western Canadian cities. We applied the IOM’s Quality of Care Domains to the OPTIC data to create binary measures of transition quality. We report the median (MED) per cent and IQR of measures met within each domain of quality.ResultsWe tracked 637 transitions over a 12-month period, with data collected from each setting. We developed 19 safety measures, 20 measures of resident-centred care, 3 measures of timely care and 5 measures of effective care. We were unable to develop measures for equitable care at an individual transfer level. Domain scores varied across individual transitions, with the highest scores in safety (MED 79%, IQR: 63–95), efficiency (66%; IQR: 66–99), and resident-centred (45%; IQR: 25–65), followed by effectiveness (36%; IQR: 16–56), and timeliness (0%; IQR: 0–50).ConclusionsOur results show variation in scores across the domains of quality suggesting that it is possible to track quality of transitions for individuals across all settings, and not only within settings. We recommend that future work in tracking quality of care be performed at several levels (LTC, region, health authority, province). Such tracking is necessary to evaluate and improve overall quality of care.

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Service use by older very frequent emergency department users: A retrospective cohort study

Berry

Street

Considine

2019

Australasian Emergency Care

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Patient-, medication- and environment-related factors affecting medication discrepancies in older patients

Cited by 4 publications

References 18 publications

Variations in drug-related problems detected by multidisciplinary teams in Norwegian nursing homes and home nursing care

Variations in drug-related problems detected by multidisciplinary teams in Norwegian nursing homes and home nursing care

Assessing quality of older persons’ emergency transitions between long-term and acute care settings: a proof-of-concept study

Service use by older very frequent emergency department users: A retrospective cohort study

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