[Medication continuity of older adults at discharge: implementation of a personalized prescription plan versus usual care].

Abstract

The personalized prescription plan (PPP) summarizes the changes made to a patient's prescription on discharge from hospital. The aim of the present study was to evaluate 30-day medication continuity in older patients whose PPP was implemented at hospital discharge. Prospective randomized controlled trial including people aged at least 75 discharged from an acute geriatric unit. The intervention consisted of medication reconciliation and review, and standardized transmission of a PPP (explaining medication changes during hospitalization) to primary care practitioners. The control group received no specific intervention. Reasons for and rates of change in discharge prescribing by primary care practitioners were assessed 30 days after discharge. The study population comprised 109 patients, 70 of whom were selected for modified intention-to-treat analysis (intervention group 34; control group 36). The mean age (standard deviation) of patients was 87.4 (6.6) years. One month after discharge, the discharge prescription was modified for 26.7% of patients in the intervention group and 31.2% in the control group (0R = 0.80, CI(95%)=[0.25; 2.45]; p = 0.91). Reasons for change were mainly adaptation to clinical events (83.3%). Medication continuity after the implementation of a PPP is similar to that of routine care, one month after hospital discharge of the elderly.