Physician Response to Written Feedback on a Medication Discrepancy Found with Their Elderly Ambulatory Patients

Abstract

Although medication discrepancies are common in elderly ambulatory patients, their family physicians appreciate assistance in correcting these discrepancies, although potential problems, such as cultural or organizational resistance to the open disclosure of medication discrepancies in medical records due to associated legal ramifications, may need to be resolved.

Discrepancies between the electronic medical record, the prescriptions in the Swedish national prescription repository and the current medication reported by patients

“…More than 80% of the patients had at least one discrepancy in the ML and PL. Overall findings are similar to concomitantly collected materials using the corresponding inclusion and exclusion criteria in six cities all over Sweden, consistent with reports that noncongruence between the ML and the patient‐reported current medication use is common . However, there were differences concerning diagnoses, patients with CHF having more discrepancies in the ML and patients with DM having fewer.…”

“…Overall findings are similar to concomitantly collected materials using the corresponding inclusion and exclusion criteria in six cities all over Sweden, 5,6 consistent with reports that noncongruence between the ML and the patient-reported current medication use is common. [7][8][9][10][11][12][13][14][15][16][17][19][20][21][22][23][24][25][26][27][28][29] However, there were differences concerning diagnoses, patients with CHF having more discrepancies in the ML and patients with DM having fewer. This is noteworthy as patients with CHF may have several caregivers, constitute a substantial part of patients admitted to the acute care units and The objectives of the present study were to compare the accuracy of the ML on the current, prescribed medications (what the patient was supposed to take) with the PL and to measure the congruence between these two information sources.…”

“…A prerequisite for adherence to the prescribed therapy is that the patient has correct, unambiguous and adequate information on the prescribed treatment with respect to what medicines he or she has been prescribed; why the medicines are prescribed, that is, the purpose of and the objectives of the treatment; how to take the medicines, for example, the administration and dosing schedule; and how long the treatment is intended to last. Noncongruence between physicians' and medical records and the prescribed, intended current medication stated by patients is common …”

“…Noncongruence between physicians' and medical records and the prescribed, intended current medication stated by patients is common. [5][6][7][8][9][10][11][12][13][14][15][16][17] E-prescribing, prescriptions generated in the physician's electronic medical record (EMR) and transmitted directly to the pharmacy computers, constitute more than 80% of all new prescriptions in Sweden. More than 70% of the population, corresponding to more than 90% of patients with prescribed medication, store their prescriptions electronically in the national prescription repository (NPR), which is accessible from any pharmacy in Sweden.…”

Patient Perceptions Regarding Electronic Prescriptions: Is the Geriatric Patient Ready?

“…To avoid such untoward events, clinicians must prescribe with full knowledge of the current drug regimen. With elderly patients, review of the medication list at every visit is crucial in assessing health status and potential for medication discontinuation, 11 yet medication discrepancies are common in elderly patients seen in ambulatory settings, 12,13 with the most frequently cited sources of discrepancy being that patients are not taking charted medications. It is hypothesized that e‐prescribing will assist in ascertaining a comprehensive and accurate medication profile.…”