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The effect of medication reconciliation in elderly patients at hospital discharge.

Midlöv, Patrik LU ; Waleij, Leila LU ; Seyfali, Mehran; Höglund, Peter LU ; Rickhag, Eva and Eriksson, Tommy LU (2012) In International Journal of Clinical Pharmacy 34(1). p.113-119
Abstract
Objective To assess the impact of medication reconciliation interventions on medication error rates when elderly patients are discharged from hospital to community care or nursing homes.Setting Elderly patients (>65 years) living in nursing homes or in their own homes with care provided by the community nursing system. Method All medical records containing information on drug treatment were collected from hospital departments, the community care service and GPs. We then identified if there were any changes in the transfer of information i.e. if the drugs were not the same as before the transfer. Two different persons independently evaluated all information about the patients' drugs to identify medication errors for three different time... (More)
Objective To assess the impact of medication reconciliation interventions on medication error rates when elderly patients are discharged from hospital to community care or nursing homes.Setting Elderly patients (>65 years) living in nursing homes or in their own homes with care provided by the community nursing system. Method All medical records containing information on drug treatment were collected from hospital departments, the community care service and GPs. We then identified if there were any changes in the transfer of information i.e. if the drugs were not the same as before the transfer. Two different persons independently evaluated all information about the patients' drugs to identify medication errors for three different time periods. During all three periods structured discharge information was used. In period 2, electronic medication lists were introduced and in period 3 we introduced specific routines and support by a clinical pharmacist to ensure prescription in the specific medication dispensing system (ApoDos). Asymptotic Linear by-Linear Association Test was used to compare number of medication errors in period 1, 2 and 3 respectively. Main outcome measure Number of medication errors per patient. Results A total of 123 patients were evaluated at discharge. For the 109 patients using the ApoDos system, there were significant differences in the number of medication errors between period 1 and 3 (P = 0.048), period 2 and 3 (P = 0.037 but not between period 1 and 2 (P = 0.41). The mean numbers of errors were 1.5, 1.1 and 0.5 for period 1, 2 and 3 respectively. The 14 patients not using the ApoDos system had on average 0.4 errors per patient. Among the 58 patients with medication errors, 34 were evaluated as having low clinical risk, 22 moderate, and 2 high clinical risk. Conclusion Medication errors are still common when elderly patients are transferred from hospital to community/primary care. The main risk factor seems to be the specific medication dispensing system (ApoDos) or rather the process on how to use it. When this system was supported by clinical pharmacists, the error rate dropped to the same level as for patients without ApoDos. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
International Journal of Clinical Pharmacy
volume
34
issue
1
pages
113 - 119
publisher
Springer
external identifiers
  • wos:000299329300017
  • pmid:22207271
  • scopus:84860789655
ISSN
2210-7703
DOI
10.1007/s11096-011-9599-6
language
English
LU publication?
yes
id
73f5ad06-0edb-4668-a6c1-51fe18f12d9a (old id 2273448)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22207271?dopt=Abstract
date added to LUP
2012-01-03 16:16:49
date last changed
2017-03-26 03:16:29
@article{73f5ad06-0edb-4668-a6c1-51fe18f12d9a,
  abstract     = {Objective To assess the impact of medication reconciliation interventions on medication error rates when elderly patients are discharged from hospital to community care or nursing homes.Setting Elderly patients (>65 years) living in nursing homes or in their own homes with care provided by the community nursing system. Method All medical records containing information on drug treatment were collected from hospital departments, the community care service and GPs. We then identified if there were any changes in the transfer of information i.e. if the drugs were not the same as before the transfer. Two different persons independently evaluated all information about the patients' drugs to identify medication errors for three different time periods. During all three periods structured discharge information was used. In period 2, electronic medication lists were introduced and in period 3 we introduced specific routines and support by a clinical pharmacist to ensure prescription in the specific medication dispensing system (ApoDos). Asymptotic Linear by-Linear Association Test was used to compare number of medication errors in period 1, 2 and 3 respectively. Main outcome measure Number of medication errors per patient. Results A total of 123 patients were evaluated at discharge. For the 109 patients using the ApoDos system, there were significant differences in the number of medication errors between period 1 and 3 (P = 0.048), period 2 and 3 (P = 0.037 but not between period 1 and 2 (P = 0.41). The mean numbers of errors were 1.5, 1.1 and 0.5 for period 1, 2 and 3 respectively. The 14 patients not using the ApoDos system had on average 0.4 errors per patient. Among the 58 patients with medication errors, 34 were evaluated as having low clinical risk, 22 moderate, and 2 high clinical risk. Conclusion Medication errors are still common when elderly patients are transferred from hospital to community/primary care. The main risk factor seems to be the specific medication dispensing system (ApoDos) or rather the process on how to use it. When this system was supported by clinical pharmacists, the error rate dropped to the same level as for patients without ApoDos.},
  author       = {Midlöv, Patrik and Waleij, Leila and Seyfali, Mehran and Höglund, Peter and Rickhag, Eva and Eriksson, Tommy},
  issn         = {2210-7703},
  language     = {eng},
  number       = {1},
  pages        = {113--119},
  publisher    = {Springer},
  series       = {International Journal of Clinical Pharmacy},
  title        = {The effect of medication reconciliation in elderly patients at hospital discharge.},
  url          = {http://dx.doi.org/10.1007/s11096-011-9599-6},
  volume       = {34},
  year         = {2012},
}