Post–Hospital Medication Discrepancies at Home

Costa, Linda L.; Byon, Ha Do

doi:10.1097/ncq.0000000000000278

Cited by 11 publications

(9 citation statements)

References 25 publications

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“…Patients included in this study were 65 years or older (median 74 years; IQR 69–80) as in comparable studies, 2,6,10 while other studies also included younger patients. 3–5,7–9 The frequency would be expected as higher in studies of older patients, as polypharmacy is high in this group. 21,22 The inclusion of OTCs in this study probably increased the number of discrepancies found; therefore, data are presented separately for regular medications, as-needed medications and OTCs.…”

Section: Discussionmentioning

confidence: 97%

“…At discharge, 14–84% of patients experience at least one medication discrepancy. 1–10 Medication discrepancies after discharge can lead to increased hospital visits 6,7,11 or preventable adverse drug events. 12 Older patients are especially at risk, as polypharmacy, comorbidities, and longer hospital stays are associated with increased medication errors.…”

Section: Introductionmentioning

confidence: 99%

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Frequency of undocumented medication discrepancies in discharge letters after hospitalization of older patients: a clinical record review study

Graabæk

Terkildsen

Lauritsen

et al. 2019

Therapeutic Advances in Drug Safety

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Transitions of care may result in medication errors, when information about a patient’s medications is not communicated sufficiently. In this clinical record review study, we aimed to evaluate the frequency of undocumented medication discrepancies at discharge from hospital and evaluate which patient characteristics could be associated with undocumented medication discrepancies. Preadmission medication lists were compared against the medication list in the discharge letters, taking into account medication changes documented in the patient record throughout the inpatient stay and in the discharge summary. Out of 200 patients, 174 (87%) were affected by at least one undocumented medication discrepancy, mostly for regular medication. Of the 1972 medications used, 744 (38%) medications were changed without documentation in the patient record, the majority being over-the-counter supplements and herbal medications. Polypharmacy at admission and discharge was associated with increased undocumented medication discrepancies. This study indicates a lack of medication reconciliation during inpatient stay. Correct and complete medication lists at admission and discharge may resolve many of these discrepancies, supporting patient safety at transitions of care.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Frequency of undocumented medication discrepancies in discharge letters after hospitalization of older patients: a clinical record review study

Graabæk

Terkildsen

Lauritsen

et al. 2019

Therapeutic Advances in Drug Safety

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show abstract

“…The unplanned return to emergency departments within 30 days of hospital discharge is rarely investigated, and the studies developed until now, alert to the importance of widening the investigations about this period, in order to increase knowledge as to the acute care based on hospitals of patients with recent discharge. 4 , 5 , 8 , 18 Analysis of the care given during hospitalization, considering only hospital readmission, does not afford an integral view of the acute care given, and limits the development of actions in favor of improved transition of care, especially of the mature patients.…”

Section: Discussionmentioning

confidence: 99%

Emergency department visits of older adults within 30 days of discharge: analysis from the pharmacotherapy perspective

Santos¹,

Dias²,

Reis³

2019

Einstein (São Paulo)

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Objective To analyze, from the pharmacotherapy perspective, the factors associated to visits of older adults to the emergency department within 30 days after discharge.Methods A cross-sectional study carried out in a general public hospital with older adults. Emergency department visit was defined as the stay of the older adult in this service for up to 24 hours. The complexity of drug therapy was determined using the Medication Regimen Complexity Index. Potentially inappropriate drugs for use in older adults were classified according to the American Geriatric Society/Beers criteria of 2015. The outcome investigated was the frequency of visits to the emergency department within 30 days of discharge. Multivariate logistic regression was performed to identify the factors associated with the emergency department visit.Results A total of 255 elderly in the study, and 67 (26.3%) visited emergency department within 30 days of discharge. Polypharmacy and potentially inappropriate medications for older adults did not present a statistically significant association. The diagnosis of heart failure and Medication Regimen Complexity Index >16.5 were positively associated with emergency department visits (OR=2.3; 95%CI: 1.04-4.94; p=0.048; and OR=2.1; 95%CI: 1.11-4.02; p=0.011), respectively. Furthermore, the diagnosis of diabetes mellitus and chronic kidney disease were protection factors for the outcome (OR=0.4; 95%CI: 0.20-0.73; p=0.004; and OR=0.3; 95%CI: 0.13-0.86; p=0.023).Conclusion The diagnosis of heart failure and Medication Regimen Complexity Index >16.5 were positively associated with the occurrence of an emergency department visit within 30 days of discharge.

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“…The occurrence of medication errors and adverse drug events among ambulatory patients in the community may be due to medication discrepancies or changes in medications that take place during transition of care. A medication discrepancy is the lack of agreement between different medication regimens during transition from acute care to post-acute care, 9 while transition of care has been identified as one of the key action areas by the World Health Organization (WHO) Global Patient Safety Challenge on Medication Safety.…”

mentioning

confidence: 99%

“…Medication discrepancies place patients at risk of medication error and adverse drug events, as these patients have 31.0% higher chances of being readmitted within 90 days of hospital discharge 9 . Recent data have shown that one third of visits to the emergency department of a teaching hospital in Malaysia were medication-related 10 …”

mentioning

confidence: 99%

Monitoring adverse drug reactions in the community settings

Rahman

2019

Bull. World Health Organ.

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Post–Hospital Medication Discrepancies at Home

Cited by 11 publications

References 25 publications

Frequency of undocumented medication discrepancies in discharge letters after hospitalization of older patients: a clinical record review study

Frequency of undocumented medication discrepancies in discharge letters after hospitalization of older patients: a clinical record review study

Emergency department visits of older adults within 30 days of discharge: analysis from the pharmacotherapy perspective

Monitoring adverse drug reactions in the community settings

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