Sources of pre-admission medication information: observational study of accuracy and availability

Fitzsimons, M; Grimes, Tamasine; Galvin, M. C.

doi:10.1111/j.2042-7174.2011.00154.x

Cited by 30 publications

(47 citation statements)

References 27 publications

(81 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The clinical pharmacist's medication history was regarded as the gold standard preadmission medication list (GSPAML) against which reconciliation was assessed. The medication history was built using a previously developed method 11. Data from the following sources were used prospectively by the investigator to identify errors: GSPAML; drug chart; discharge medication list (prescription and summary); all entries in the healthcare record regarding medication use.…”

Section: Methodsmentioning

confidence: 99%

“…MedRec was defined by the Institute for Healthcare Improvement (IHI) 2006 as “the process of obtaining and maintaining an accurate and detailed list of all prescribed and non-prescribed drugs a patient is taking, including dosage and frequency, through all healthcare encounters and comparing the physician's admission, transfer, and/ or discharge orders to that list, recognizing any discrepancies, and documenting any changes, thus resulting in a complete list of medications, accurately communicated” 6. It is time consuming and labour intensive,11 12 and scarce resources should be prioritised for it only where there is evidence of its value to care. Two recent systematic reviews investigating hospital-based MedRec practices concluded that while there is a need for further comparative studies, available evidence suggests benefits from interventions that involve pharmacy staff 3 13.…”

Section: Background and Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Collaborative pharmaceutical care in an Irish hospital: uncontrolled before-after study

et al. 2014

View full text Add to dashboard Cite

BackgroundWe investigated the benefits of the Collaborative Pharmaceutical Care in Tallaght Hospital (PACT) service versus standard ward-based clinical pharmacy in adult inpatients receiving acute medical care, particularly on prevalence of medication error and quality of prescribing.MethodsUncontrolled before-after study, undertaken in consecutive adult medical inpatients admitted and discharged alive, using at least three medications. Standard care involved clinical pharmacists being ward-based, contributing to medication history taking and prescription review, but not involved at discharge. The innovative PACT intervention involved clinical pharmacists being team-based, leading admission and discharge medication reconciliation and undertaking prescription review. Primary outcome measures were prevalence per patient of medication error and potentially severe error. Secondary measures included quality of prescribing using the Medication Appropriateness Index (MAI) in patients aged ≥65 years.FindingsSome 233 patients (112 PACT, 121 standard) were included. PACT decreased the prevalence of any medication error at discharge (adjusted OR 0.07 (95% CI 0.03 to 0.15)); number needed to treat (NNT) 3 (95% CI 2 to 3) and no PACT patient experienced a potentially severe error (NNT 20, 95% CI 10 to 142). In patients aged ≥65 years (n=108), PACT improved the MAI score from preadmission to discharge (Mann–Whitney U p<0.05; PACT median −1, IQR −3.75 to 0; standard care median +1, IQR −1 to +6).ConclusionsPACT, a collaborative model of pharmaceutical care involving medication reconciliation and review, delivered by clinical pharmacists and physicians, at admission, during inpatient care and at discharge was protective against potentially severe medication errors in acute medical patients and improved the quality of prescribing in older patients.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Background and Introductionmentioning

confidence: 99%

Collaborative pharmaceutical care in an Irish hospital: uncontrolled before-after study

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Gold standard preadmission medication list 211 A list which accurately reflects the medications the patient 212 was actually using prior to admission to hospital, taking 213 into account any non-compliance and non-prescription 214 medications [18]. At NGH this list is obtained by the 215 clinical pharmacist using at least two reliable sources of 216 information.…”

mentioning

confidence: 99%

Interdisciplinary collaboration in the provision of a pharmacist-led discharge medication reconciliation service at an Irish teaching hospital

Holland

2015

Int J Clin Pharm

View full text Add to dashboard Cite

show abstract

“…The clinical pharmacist's medication history was regarded as the gold standard pre-admission medication list; a previously developed and appraised method employed in two Irish hospitals 21 23. The investigator performed medication reconciliation and developed a best possible discharge medication list, against which the documented discharge prescription was assessed.…”

Section: Methodsmentioning

confidence: 99%

Impact of the Collaborative Pharmaceutical Care at Tallaght Hospital (PACT) model on medication appropriateness of older patients

et al. 2015

Self Cite

View full text Add to dashboard Cite

ObjectivesA high prevalence of potentially inappropriate prescribing (PIP) has been identified in older patients in Ireland. The impact of the Collaborative Pharmaceutical Care at Tallaght Hospital (PACT) model on the medication appropriateness of acute hospitalised older patients during admission and at discharge is reported. MethodsUncontrolled before-after study. The study population for this study was medical patients aged 65 years, using 3 regular medicines at admission, taken from a previous before-after study. Standard care involved clinical pharmacists being ward-based, contributing to medication history taking and prescription review, but not involved at discharge. The innovative PACT model involved clinical pharmacists being physician team-based, leading admission and discharge medication reconciliation and undertaking prescription review, with authority to change the prescription during admission or at discharge. The primary outcome was the Medication Appropriateness Index (MAI) score applied pre-admission, during admission and at discharge. ResultsSome 108 patients were included (48 PACT, 60 standard). PACT significantly improved the MAI score from pre-admission to admission (mean difference 2.4, 95% confidence interval (95CI) 1.0-3.9, p<0.005), and from pre-admission to discharge (mean difference 4.0, 95CI 1.7-6.4, p<0.005). PACT resulted in significantly fewer drugs with one or more inappropriate rating at discharge (PACT 15.0%, standard 30.5%, p<0.001). The MAI criteria responsible for most inappropriate ratings was "correct directions" (4.8% PACT, 17.3% standard), expense (5.3%, 5.7%) and dosage (4.0%, 0.6%). PACT suggestions to optimize medication use were accepted more frequently, and earlier in the hospital episode, than standard care (96.7%, 69.3%, p<0.05). ConclusionCollaborative pharmaceutical care between physicians and pharmacists from admission to discharge, with authority for pharmacists to amend the prescription, improves medication appropriateness in older hospitalised Irish patients. Key messagesWhat is already known on this subject - Older patients are at greater risk of drug related problems, including adverse drug effects, than younger patients.

show abstract

Sources of pre-admission medication information: observational study of accuracy and availability

Abstract: Community pharmacy and GP staff were identified as the most available and accurate sources of PAM information and should be prioritised when undertaking admission medication reconciliation in a busy clinical environment.

Cited by 30 publications

References 27 publications

Collaborative pharmaceutical care in an Irish hospital: uncontrolled before-after study

Collaborative pharmaceutical care in an Irish hospital: uncontrolled before-after study

Interdisciplinary collaboration in the provision of a pharmacist-led discharge medication reconciliation service at an Irish teaching hospital

Impact of the Collaborative Pharmaceutical Care at Tallaght Hospital (PACT) model on medication appropriateness of older patients

Contact Info

Product

Resources

About