Clinical outcomes from the use of Medication Report when elderly patients are discharged from hospital
- 415 Downloads
Objective The objective of this study was to investigate whether a Medication Report also can reduce the number of patients with clinical outcomes due to medication errors. Method A prospective intervention study with retrospective controls on patients at three departments at Lund University Hospital, Sweden that where transferred to primary care. The intervention group, where patients received a Medication Report at discharge, was compared with a control group with patients of the same age, who were not given a Medication Report when discharged from the same ward one year earlier. For patients with at least one medication error all contacts with hospital or primary care within 3 months after discharge were identified. For each contact it was evaluated whether this was caused by the medication error. We also compared medication errors that have been evaluated as high or moderate clinical risk with medication errors without clinical risk. Main outcome measures Need for medical care in hospital or primary care within three months after discharge from hospital. Medical care is readmission to hospital as well as visits of study population to primary and out-patient secondary health care. Results The use of Medication Report reduced the need for medical care due to medication errors. Of the patients with Medication Report 11 out of 248 (4.4%) needed medical care because of medication errors compared with 16 out of 179 (8.9%) of patients without Medication Report (p = 0.049). The use of a Medication Report significantly reduced the risk of any consequences due to medication errors, p = 0.0052. These consequences included probable and possible care due to medication error as well as administrative procedures (corrections) made by physicians in hospital or primary care. Conclusions The Medication Report seems to be an effective tool to decrease adverse clinical consequences when elderly patients are discharged from hospital care.
KeywordsClinical outcomes Discharge planning Drug-related problems Medication errors Seamless care Sweden
We thank the students Linda Andersson, Hanna Fredricson, and Nilla Swärdén for collecting all information on the patients’ drugs.
The department of Primary Care Development, The department of Research and Development in the county of Skåne, Apoteket AB and the Faculty of Medicine, Lund University.
- 3.Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;3:533–43.Google Scholar
- 4.Leape LL. Preventing adverse drug events. Am J Health Syst Pharm. 1995;4:379–82.Google Scholar
- 14.The Uppsala Monitoring Centre. The use of the WHO-UMC system for standardised case causality assessment [homepage on the Internet]. [cited June 2008]; 2008. Available from: http://www.who-umc.org/graphics/4409.pdf
- 20.Gleason KM, Groszek JM, Sullivan C, Rooney D, Barnard C, Noskin GA. Reconciliation of discrepancies in medication histories and admission orders of newly hospitalized patients. Am J Health Syst Pharm. 2004;16:1689–95.Google Scholar