Congruence on medication between patients and physicians involved in patient course

Abstract

Congruence between sources of information on medication throughout patient courses cannot be obtained with separate medication charts. Discrepancies among patient, general practitioner and hospital give rise to a definitive risk of serious untoward effects.

Impact of Medication Reconciliation upon Discharge on Reducing Medication Errors

“…These discrepancies on admission may result in inappropriate medication therapy during the hospital stay, which often carries over to discharge. Foss et al [8]. Conducted a study in Denmark which demonstrated that 48% of all drugs had a discrepancy when medication lists were compared between the hospital and patient immediately following discharge.…”

Discrepancies between sources providing the medication histories of acutely hospitalised patients

“…Patients are often the primary source of providing their own medication status at the time of hospitalisation. Due to the risk of recall bias in patients, it is often necessary to supplement their information with that of others such as their general practitioner (GP), in-home care provider or pharmacy [1,5,6]. However, even given supplementary information, it has proven difficult to uncover patients' actual medication status upon hospitalisation, as there can be discrepancies between various medication lists due to lack of updating, among other reasons [1,2,7].…”

“…However, even given supplementary information, it has proven difficult to uncover patients' actual medication status upon hospitalisation, as there can be discrepancies between various medication lists due to lack of updating, among other reasons [1,2,7]. An incomplete medication history promotes the risk of medication error and misinterpretation of symptoms [1,2,6,[8][9][10]. Several methods to improve medication history have been tried in Denmark and elsewhere, such as questionnaires, structured medication interviews, a review of the medicines patients have brought with them, a prescription list from the GP and prescription data from the pharmacy [5,6,8,9,[11][12][13][14].…”

“…Due to the risk of recall bias in patients, it is often necessary to supplement their information with that of others such as their general practitioner (GP), in-home care provider or pharmacy [1,5,6]. However, even given supplementary information, it has proven difficult to uncover patients' actual medication status upon hospitalisation, as there can be discrepancies between various medication lists due to lack of updating, among other reasons [1,2,7]. An incomplete medication history promotes the risk of medication error and misinterpretation of symptoms [1,2,6,[8][9][10].…”

“…Research shows that many problems are connected with the transition of patients from the primary to the secondary sector [1][2][3][4]. Patients are often the primary source of providing their own medication status at the time of hospitalisation.…”