Medication Errors Immediately After Hospitalization.

[Argirios Argiriou]

Allan S. Brett, MD reviewing Mixon AS et al. Mayo Clin Proc 2014 Aug.

In a prospective study, errors were documented in half of patients.

In a recent study, one in five older adults experienced adverse events associated with medications shortly after a hospitalization (NEJM JW Gen Med Jan 9 2014). Discordance between what patients have been prescribed and what they actually are taking might contribute to this problem. To explore this issue, researchers compared patients' presumed postdischarge medications (according to the list patients received at hospital discharge) with medications they reported actually taking (according to phone interviews conducted 2–3 days after discharge). Analysis involved 471 patients (mean age, 59) who were hospitalized for acute coronary syndrome or decompensated heart failure; they reported taking an average of 12 medications after discharge.

In 51% of patients, researchers documented at least one discordant medication (median, 2); 27% of patients were not taking at least one prescribed medication, and 36% were taking at least one nonprescribed medication. About 60% of patients misunderstood indication, dose, or frequency for at least one cardiac medication. Better health literacy and numeracy were associated with lower probability of medication misunderstandings.
Comment

The 50% discordance between hospital discharge medication lists and patients' self-reported medications validates what we often see at follow-up visits after hospitalizations. In my experience, some of the currently used “medication reconciliation” procedures and printouts implemented at hospital discharge are potentially confusing. Moreover, patients might find that drugs prescribed at hospital discharge aren't included in their insurance companies' drug formularies or are just unaffordable. Nothing short of labor-intensive communication among providers, patients, insurers, and pharmacies is likely to solve this problem.


Citation(s):

Mixon AS et al. Characteristics associated with postdischarge medication errors. Mayo Clin Proc 2014 Aug; 89:1042. (Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος)

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