Medication reconciliation practices on discharge into primary care homes in Prince George, British Columbia
Canadian Pharmacists Conference ePoster Library. Pammett R. Jun 25, 2016; 132124
Robert Pammett
Robert Pammett
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Abstract
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OBJECTIVES: Medication reconciliation is an integral part of safe medication practices, and should occur at all stages of hospital transition, including discharge to the primary care home (PCH). Ensuring that the PCH has an up to date list of patient medications after discharge can help avoid medication misadventures. The objectives of this study were:(1) to determine the proportion of patients who had a discharge medication list communicated to the primary care home which contained discrepancies from the hospital medication list, and;(2) to categorize discrepancies as prescription medication, non-prescription medication, or medication dose.,METHODS: Two PCHs were recruited to participate in the retrospective chart review. Records of 50 patients who received a hospital discharge from June 1 2014 to May 31 2015 were identified at each PCH. The list of hospital medications at discharge was compared to the medication list that was communicated to the PCH at discharge. Discrepancies between these lists were identified and categorized, as was the medium in which the medication list was communicated to the PCH.,RESULTS: Seventy eight cases were included in the final data analysis. Mean age of patients was 46.7 years, 59% being female. The mean number of medications taken was 6.3 per case. Four cases had no medication use. All discharge medication information was communicated via a dictated discharge summary. The total number of discrepancies identified was 280, a mean of 3.6 per case. The majority of discrepancies were prescription medication omissions or errors (69%). The remaining discrepancies were non-prescription medication omissions or errors (18%) and medication dose discrepancies (13%).,CONCLUSIONS: A large number of discrepancies were present between the hospital chart and the discharge summary that was sent to the PCH. Improving communication of the medication list at discharge should be encouraged to reduce potential medication errors.
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