High Prevalence of Medication Discrepancies Between Home Health Referrals and Centers for Medicare and Medicaid Services Home Health Certification and Plan of Care and Their Potential to Affect Safety of Vulnerable Elderly Adults

Abstract

Discrepancies between HH and referring provider lists are common. Future work is needed to address possible safety and care coordination implications of discrepancies in this highly complex population.

Hospitalization Risk and Potentially Inappropriate Medications among Medicare Home Health Nursing Patients

“…In a study of 770 patients referred from hospitals to HH, 100% of patient medication lists had at least one error, including inappropriate medications and dosing errors. 45 A similar study found discrepancies between home nurse medication review and admission information in 88.4% of HH patients. 46 Given the present findings, HH nurses may serve a critical role in improving communication between hospitals, HH agencies, and other providers.…”

High-Value Home Health Care for Patients With Heart Failure

“…A recent meta-analysis of pharmacist-led medication reconciliation at hospital transitions found reductions in 30-day drug-related readmissions (relative risk 0.33; 95% confidence interval, 0.20–0.53) and 30-day all-cause hospital readmissions (RR, 0.81; 95% confidence interval, 0.70–0.95). 33 Because 94% to 100% of HHC patients have at least 1 discrepancy between hospital discharge and HHC medication lists, 34,35 HHC nurse collaboration with pharmacists to improve medication reconciliation could improve outcomes for patients with HF. Furthermore, because functional impairment increases the risk for hospital readmission in patients with HF, 36 physical therapists also likely have a central role in effective post-acute HHC.…”

Incorporating home healthcare nurses’ admission information needs to inform data standards

“…Missed medications, wrong doses, and other medication errors due to inability to self-manage medication can lead to adverse events and unfortunately are too common during transitions in care. 8 Patients who cannot self-manage medications may need to be visited earlier or more often, may need a social work consult to help with obtaining or affording medications, and could need medication management added to the care plan as a problem. Therefore, timely medication reconciliation would be important.…”