Reducing Adverse Prescribing Discrepancies Following Hospital Discharge

Abstract

General medical patients from an east London teaching hospital were recruited into intervention and comparison groups. Those recruited into the intervention group were given a copy of a letter listing their drugs prescribed at discharge and asked to give it to their regular community pharmacist when they went to obtain their prescribed drugs following hospital discharge. A comparison group returned home without a letter for their community pharmacist. Recruited patients were visited in their own homes once their community supply of drugs had been obtained. The frequency of all discrepancies between the prescribed drugs were compared for both groups. A consensus panel judged the importance of the discrepancies observed. The numbers deemed as clinically significant were compared for both groups, as the effect of the intervention. The 501 patients followed up (264 in the intervention group and 237 in the comparison group) were prescribed 2,736 drugs. The number of unintentional discrepancies observed was lower for the intervention group (32.2 per cent, 454/1,408) than for the : omparison group (52.7 per cent, 700/1,328) (chi-squared 117.38, P<O.OOl). The number of discrepancies judged to have a definite adverse effect was lower in the intervention group (1.6 per cent, 23/1,408) than in the comparison group (3.1 ?er cent, 41/1,328) (chi-squared 6.32, RO.01).Discharging 19 patients with such information to take to their community ?harmacist would result in the prevention of one unintentional discrepancy laving a definite adverse effect. Providing community pharmacists with a copy of ?atients' discharge summaries is an effective method of reducing unintentional iiscrepancies, with measurable patient benefit.

Comprehensive medication history: the need for the implementation of medication reconciliation processes

“…Other studies comparing pharmacist-acquired medication histories with those obtained by physicians reported similar results, with an unintentional discrepancy being reported for around 60% of medicines (13,16). The percentage of medicines presented with a discrepancy was lower (approx.…”

Medication report reduces number of medication errors when elderly patients are discharged from hospital

“…In a review of 22 studies the authors concluded that medication history errors are common at the time of hospital admission [17]. Different interventions have had some effect on the number of medication errors or emergency department visits [18,19]. We welcome studies that compare different interventions or combinations of interventions in this field.…”

Improved quality in the hospital discharge summary reduces medication errors—LIMM: Landskrona Integrated Medicines Management

“…The process involves comparing the Studies from the UK, Holland, Canada and the U.S. have been based on development of models for medication reconciliation at hospital discharge. This includes telephone follow-up by a pharmacist [12], and discharge summaries to pharmacies [13,14,[25][26][27][28][29] and to the general practitioner [27,28,30]. To our knowledge, our discharge summary is the first systematic tool enabling information to be produced for the patient and to the next level of care by the responsible person, the physician.…”

“…A review article reports that of the medication errors identified, 11-59% were thought to be of clinical importance [3]. Various types of medication errors are frequent in hospitals [4,5] and in the interface between care levels [6][7][8][9][10][11][12][13][14][15][16]. Insufficient quality in the transfer of information on a patient's medications has recently been highlighted as one of the most important problems in health care, and international and national programs have been developed for information and help [16].…”