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- Midlöv, Patrik, et al.
(author)
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The effect of medication reconciliation in elderly patients at hospital discharge.
- 2012
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In: International Journal of Clinical Pharmacy. - : Springer Science and Business Media LLC. - 2210-7703 .- 2210-7711. ; 34:1, s. 113-119
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Journal article (peer-reviewed)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.
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| 2. |
- Waleij, Leila, et al.
(author)
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The rate and nature of medication errors among elderly upon admission to hospital after implementation of clinical pharmacist-led medication reconciliation
- 2014
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In: European Journal of Hospital Pharmacy: Science and Practice. - : BMJ. - 2047-9964 .- 2047-9956. ; 21:3, s. 156-160
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Journal article (peer-reviewed)abstract
- Objectives To determine the frequency and nature of erroneous transfer of medication information (medication errors) upon admission to hospital and to study the effect of medication reconciliation. Methods Included patients were 65years of age or older, were living in nursing homes or in their own home with care provided by the community nursing system and had been admitted to hospital. The patients' medication lists from the community were compared with the hospital medication lists upon admission in order to study the discrepancies between the lists. The proportion of errors that were corrected by day 4 of hospitalisation was also studied as a measure of the effect of medication reconciliation conducted by clinical pharmacists who aimed to identify the patients' accurate and complete medication history. Results A total of 149 patients were included over a 10-month period. In 68 (46%) patients, there occurred at least one medication error, with an average of 0.95 errors per patient. Overall, 8.0% of all drug transfers were found to be incorrect. The clinical pharmacists detected all medication errors upon admission and 43% of them were corrected before day 4 of hospitalisation. Conclusions Medication errors upon admission to hospital are common; use of clinical pharmacists in the admission medication reconciliation process appears to be a useful method to reduce medication errors, but since our study lacked a control group further studies are needed to show the actual impact of pharmacist-led medication reconciliation upon admission to hospital. Furthermore, more actions are needed to enhance the safety and quality of medication information transfers.
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