Frequency of undocumented medication discrepancies in discharge letters after hospitalization of older patients

a clinical record review study

Trine Graabæk, Babette Gorm Terkildsen, Kira Emilie Lauritsen, Anna Birna Almarsdóttir

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Transitions of care may result in medication errors, when information about a patient's medications is not communicated sufficiently. In this clinical record review study, we aimed to evaluate the frequency of undocumented medication discrepancies at discharge from hospital and evaluate which patient characteristics could be associated with undocumented medication discrepancies. Preadmission medication lists were compared against the medication list in the discharge letters, taking into account medication changes documented in the patient record throughout the inpatient stay and in the discharge summary. Out of 200 patients, 174 (87%) were affected by at least one undocumented medication discrepancy, mostly for regular medication. Of the 1972 medications used, 744 (38%) medications were changed without documentation in the patient record, the majority being over-the-counter supplements and herbal medications. Polypharmacy at admission and discharge was associated with increased undocumented medication discrepancies. This study indicates a lack of medication reconciliation during inpatient stay. Correct and complete medication lists at admission and discharge may resolve many of these discrepancies, supporting patient safety at transitions of care.

OriginalsprogEngelsk
TidsskriftTherapeutic Advances in Drug Safety
ISSN2042-0986
DOI
StatusE-pub ahead of print - 2019

Fingeraftryk

Patient Transfer
Inpatients
Patient Safety
Documentation

Citer dette

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Frequency of undocumented medication discrepancies in discharge letters after hospitalization of older patients : a clinical record review study. / Graabæk, Trine; Terkildsen, Babette Gorm; Lauritsen, Kira Emilie; Almarsdóttir, Anna Birna.

I: Therapeutic Advances in Drug Safety, 2019.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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AU - Terkildsen, Babette Gorm

AU - Lauritsen, Kira Emilie

AU - Almarsdóttir, Anna Birna

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AB - Transitions of care may result in medication errors, when information about a patient's medications is not communicated sufficiently. In this clinical record review study, we aimed to evaluate the frequency of undocumented medication discrepancies at discharge from hospital and evaluate which patient characteristics could be associated with undocumented medication discrepancies. Preadmission medication lists were compared against the medication list in the discharge letters, taking into account medication changes documented in the patient record throughout the inpatient stay and in the discharge summary. Out of 200 patients, 174 (87%) were affected by at least one undocumented medication discrepancy, mostly for regular medication. Of the 1972 medications used, 744 (38%) medications were changed without documentation in the patient record, the majority being over-the-counter supplements and herbal medications. Polypharmacy at admission and discharge was associated with increased undocumented medication discrepancies. This study indicates a lack of medication reconciliation during inpatient stay. Correct and complete medication lists at admission and discharge may resolve many of these discrepancies, supporting patient safety at transitions of care.

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