Medication details documented on hospital discharge: cross-sectional observational study of factors associated with medication non-reconciliation.

Hdl Handle:
http://hdl.handle.net/10147/207856
Title:
Medication details documented on hospital discharge: cross-sectional observational study of factors associated with medication non-reconciliation.
Authors:
Grimes, Tamasine C; Duggan, Catherine A; Delaney, Tim P; Graham, Ian M; Conlon, Kevin C; Deasy, Evelyn; Jago-Byrne, Marie-Claire; O' Brien, Paul
Affiliation:
Pharmacy Department, Adelaide and Meath Hospital, incorporating the National, Children's Hospital (AMNCH), Tallaght, Dublin 24 School of Pharmacy , Trinity, College, Dublin 2, Ireland. tagrimes@tcd.ie
Citation:
Br J Clin Pharmacol. 2011 Mar;71(3):449-57. doi:, 10.1111/j.1365-2125.2010.03834.x.
Journal:
British journal of clinical pharmacology
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207856
DOI:
10.1111/j.1365-2125.2010.03834.x
PubMed ID:
21284705
Abstract:
AIMS: Movement into or out of hospital is a vulnerable period for medication safety. Reconciling the medication a patient is using before admission with the medication prescribed on discharge, and documenting any changes (medication reconciliation) is recommended to improve safety. The aims of the study were to investigate the factors contributing to medication reconciliation on discharge, and identify the prevalence of non-reconciliation. METHODS: The study was a cross-sectional, observational survey using consecutive discharges from purposively selected services in two acute public hospitals in Ireland. Medication reconciliation, potential for harm and unplanned re-admission were investigated. RESULTS: Medication non-reconciliation was identified in 50% of 1245 inpatient episodes, involving 16% of 9569 medications. The majority of non-reconciled episodes had potential to result in moderate (63%) or severe (2%) harm. Handwritten rather than computerized discharges (adjusted odds ratio (adjusted OR) 1.60, 95% CI 1.11, 2.99), increasing number of medications (adjusted OR 1.26, 95% CI 1.21, 1.31) or chronic illness (adjusted OR 2.08, 95% CI 1.33, 3.24) were associated with non-reconciliation. Omission of endocrine, central nervous system and nutrition and blood drugs was more likely on discharge, whilst omission on admission and throughout inpatient care, without documentation, was more likely for obstetric, gynaecology and urinary tract (OGU) or respiratory drugs. Documentation in the discharge communication that medication was intentionally stopped during inpatient care was less likely for cardiovascular, musculoskeletal and OGU drugs. Errors involving the dose were most likely for respiratory drugs. CONCLUSIONS: The findings inform strategies to facilitate medication reconciliation on discharge from acute hospital care.
Language:
eng
MeSH:
Adolescent; Adult; Aged; Aged, 80 and over; Communication; Continuity of Patient Care/standards; Cross-Sectional Studies; Humans; Ireland; Medical History Taking/*methods/standards/statistics & numerical data; Medication Errors/*prevention & control/statistics & numerical data; Medication Reconciliation/*methods/standards/statistics & numerical data; Middle Aged; Patient Discharge/*standards; Young Adult
ISSN:
1365-2125 (Electronic); 0306-5251 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorGrimes, Tamasine Cen_GB
dc.contributor.authorDuggan, Catherine Aen_GB
dc.contributor.authorDelaney, Tim Pen_GB
dc.contributor.authorGraham, Ian Men_GB
dc.contributor.authorConlon, Kevin Cen_GB
dc.contributor.authorDeasy, Evelynen_GB
dc.contributor.authorJago-Byrne, Marie-Claireen_GB
dc.contributor.authorO' Brien, Paulen_GB
dc.date.accessioned2012-02-01T10:48:12Z-
dc.date.available2012-02-01T10:48:12Z-
dc.date.issued2012-02-01T10:48:12Z-
dc.identifier.citationBr J Clin Pharmacol. 2011 Mar;71(3):449-57. doi:, 10.1111/j.1365-2125.2010.03834.x.en_GB
dc.identifier.issn1365-2125 (Electronic)en_GB
dc.identifier.issn0306-5251 (Linking)en_GB
dc.identifier.pmid21284705en_GB
dc.identifier.doi10.1111/j.1365-2125.2010.03834.xen_GB
dc.identifier.urihttp://hdl.handle.net/10147/207856-
dc.description.abstractAIMS: Movement into or out of hospital is a vulnerable period for medication safety. Reconciling the medication a patient is using before admission with the medication prescribed on discharge, and documenting any changes (medication reconciliation) is recommended to improve safety. The aims of the study were to investigate the factors contributing to medication reconciliation on discharge, and identify the prevalence of non-reconciliation. METHODS: The study was a cross-sectional, observational survey using consecutive discharges from purposively selected services in two acute public hospitals in Ireland. Medication reconciliation, potential for harm and unplanned re-admission were investigated. RESULTS: Medication non-reconciliation was identified in 50% of 1245 inpatient episodes, involving 16% of 9569 medications. The majority of non-reconciled episodes had potential to result in moderate (63%) or severe (2%) harm. Handwritten rather than computerized discharges (adjusted odds ratio (adjusted OR) 1.60, 95% CI 1.11, 2.99), increasing number of medications (adjusted OR 1.26, 95% CI 1.21, 1.31) or chronic illness (adjusted OR 2.08, 95% CI 1.33, 3.24) were associated with non-reconciliation. Omission of endocrine, central nervous system and nutrition and blood drugs was more likely on discharge, whilst omission on admission and throughout inpatient care, without documentation, was more likely for obstetric, gynaecology and urinary tract (OGU) or respiratory drugs. Documentation in the discharge communication that medication was intentionally stopped during inpatient care was less likely for cardiovascular, musculoskeletal and OGU drugs. Errors involving the dose were most likely for respiratory drugs. CONCLUSIONS: The findings inform strategies to facilitate medication reconciliation on discharge from acute hospital care.en_GB
dc.language.isoengen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdulten_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshCommunicationen_GB
dc.subject.meshContinuity of Patient Care/standardsen_GB
dc.subject.meshCross-Sectional Studiesen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIrelanden_GB
dc.subject.meshMedical History Taking/*methods/standards/statistics & numerical dataen_GB
dc.subject.meshMedication Errors/*prevention & control/statistics & numerical dataen_GB
dc.subject.meshMedication Reconciliation/*methods/standards/statistics & numerical dataen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshPatient Discharge/*standardsen_GB
dc.subject.meshYoung Adulten_GB
dc.titleMedication details documented on hospital discharge: cross-sectional observational study of factors associated with medication non-reconciliation.en_GB
dc.contributor.departmentPharmacy Department, Adelaide and Meath Hospital, incorporating the National, Children's Hospital (AMNCH), Tallaght, Dublin 24 School of Pharmacy , Trinity, College, Dublin 2, Ireland. tagrimes@tcd.ieen_GB
dc.identifier.journalBritish journal of clinical pharmacologyen_GB
dc.description.provinceLeinster-

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