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

Version 2 2024-06-03, 23:03
Version 1 2017-01-18, 11:52
journal contribution
posted on 2024-06-03, 23:03 authored by E Manias, N Annakis, Julie ConsidineJulie Considine, R Weerasuriya, S Kusljic
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.

History

Journal

Collegian

Volume

24

Pagination

571-577

Location

Amsterdam, The Netherlands

ISSN

1322-7696

eISSN

1876-7575

Language

eng

Publication classification

C Journal article, C1 Refereed article in a scholarly journal

Copyright notice

2016, Australian College of Nursing

Issue

6

Publisher

Elsevier