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Patient-, medication- and environment-related factors affecting medication discrepancies in older patients

Manias, Elizabeth, Annakis, Noel, Considine, Julie, Weerasuriya, Rona and Kusljic, Snezana 2016, Patient-, medication- and environment-related factors affecting medication discrepancies in older patients, Collegian, vol. In Press, pp. 1-7, doi: 10.1016/j.colegn.2016.10.012.

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Title Patient-, medication- and environment-related factors affecting medication discrepancies in older patients
Author(s) Manias, ElizabethORCID iD for Manias, Elizabeth orcid.org/0000-0002-3747-0087
Annakis, Noel
Considine, JulieORCID iD for Considine, Julie orcid.org/0000-0003-3801-2456
Weerasuriya, Rona
Kusljic, Snezana
Journal name Collegian
Volume number In Press
Start page 1
End page 7
Total pages 7
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2016-11-13
ISSN 1322-7696
1876-7575
Keyword(s) medication discrepancies
older people
subacute care
transition of care
nursing
medicine
pharmacy
Summary Background: As patients move across different clinical settings, medication changes are likely to occur. Aim: To identify patient-, medication- and environment-related factors associated with unintentional medication discrepancies in older patients, who were admitted to hospital via an emergency department and who had a subacute care admission at some point following hospital admission.

Methods: A retrospective clinical audit was undertaken using a stratified random sampling approach over a 14-month period. Medical records of patients aged 65 years or over were collected from five hospitals.

Findings: Data were collected from 426 older patients. Of these patients, 169 (39.7%) had at least one unexplained medication discrepancy. Patients without social supports had 2.956 greater odds of experiencing an unexplained medication discrepancy (95% CI 1.870-4.671), p<0.0001. As the number of prescribed medications increased upon admission to the emergency department, patients had 1.125 greater odds of experiencing an unexplained medication discrepancy (95% CI 1.035-1.223), p=0.006. Patients discharged to destinations other than their home had 2.714 increased odds (95% CI 1.317-5.594), p=0.007 while those experiencing more than four transition points of care had 2.476 increased odds (95% CI 1.208-5.074), p=0.013, of experiencing an unexplained medication discrepancy. A significant association existed between the prevalence of unexplained medication discrepancies and hospital readmission within six months, χ2 =36.496, df=1, p<0.001.

Conclusion: Great care is needed in managing complex medication regimens of older people with multiple chronic conditions, especially those who move across several transition points of care.
Language eng
DOI 10.1016/j.colegn.2016.10.012
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
1110 Nursing
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Australian College of Nursing
Persistent URL http://hdl.handle.net/10536/DRO/DU:30090676

Document type: Journal Article
Collections: School of Nursing and Midwifery
Centre for Quality and Patient Safety
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