Malin Olsen Syversen, Mikas Glatkauskas, Sandra Johanne Sedeniussen, Monica Hauge, Steffi Benny, Kristine Horgen, Marianne Lea, Rita Romskaug, Anne Mette Njaastad, Torunn Wibe, Karin Svensberg, Liv Mathiesen
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引用次数: 0
Abstract
Background: Inadequate information flow in the transition from hospital to home poses a challenge to medication safety, especially for patients with multiple long-term conditions (MLTCs).
Purpose: To investigate the frequency, categories, underlying reasons, and potential clinical relevance of medication discrepancies (MDs) by comparing medication lists in hospital discharge summaries with actual medication use after discharge in patients with MLTCs.
Methods: Home-dwelling adult patients with MLTCs, using minimum four medications were included near the time of their planned discharge, from one internal medicine and two geriatric wards in Oslo, to this cross-sectional observational study. Medication reconciliation was performed 1-2 weeks post-discharge. Discrepancies between the medication list in the discharge summary and the patient's medication use were classified into six categories. A panel assessed the potential clinical relevance of the MDs in a short-term and long-term perspective.
Results: 150 patients, median age 75 years (range 22-94), were included. 132 (88 %) had at least one MD, with a median of 3 per patient (range 0-10). The most common MDs involved medications in use although not listed in the discharge summary. Apparent lack of or insufficient medication reconciliation during the hospital stay was the most frequent reason for MDs. Of the MDs, 5.5 % and 28 % were assessed to be of potential clinical relevance in the short-term and long-term perspective, respectively.
Conclusion: Almost all patients had MDs following hospital discharge. The potential clinical relevance increases over time if MDs are not corrected. Our findings highlight the need for more effective interventions to ensure medication safety in care transitions for this vulnerable population.
期刊介绍:
Research in Social and Administrative Pharmacy (RSAP) is a quarterly publication featuring original scientific reports and comprehensive review articles in the social and administrative pharmaceutical sciences. Topics of interest include outcomes evaluation of products, programs, or services; pharmacoepidemiology; medication adherence; direct-to-consumer advertising of prescription medications; disease state management; health systems reform; drug marketing; medication distribution systems such as e-prescribing; web-based pharmaceutical/medical services; drug commerce and re-importation; and health professions workforce issues.