ArticlePloS one2017
Effect of therapeutic interchange on medication reconciliation during hospitalization and upon discharge in a geriatric population.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Unintended medication discrepancies and associated factors upon patient admission to the internal medicine wards: identified through medication reconciliation.BMC health services research · 2022Article
- Impact of clinical decision support therapeutic interchanges on hospital discharge medication omissions and duplications.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2021Article
- Mapping of drug-related problems among older adults conciliating medical and pharmaceutical approaches.European geriatric medicine · 2021Review
- Evaluation of In-Hospital Management of Inhaler Therapy for Chronic Obstructive Pulmonary Disease.The Canadian journal of hospital pharmacy · 2021Article
- Effect of Therapeutic Interchange on Medication Changes Between Admission and Discharge.Hospital pharmacy · 2020Article
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Authors and funding
3 authors.
Funding
Abstract
backgroundTherapeutic interchange of a same class medication for an outpatient medication is a widespread practice during hospitalization in response to limited hospital formularies. However, therapeutic interchange may increase risk of medication errors. The objective was to characterize the prevalence and safety of therapeutic interchange. METHODS AND
findingsSecondary analysis of a transitions of care study. We included patients over age 64 admitted to a tertiary care hospital between 2009-2010 with heart failure, pneumonia, or acute coronary syndrome who were taking a medication in any of six commonly-interchanged classes on admission: proton pump inhibitors (PPIs), histamine H2-receptor antagonists (H2 blockers), hydroxymethylglutaryl CoA reductase inhibitors (statins), angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and inhaled corticosteroids (ICS). There was limited electronic medication reconciliation support available. Main measures were presence and accuracy of therapeutic interchange during hospitalization, and rate of medication reconciliation errors on discharge. We examined charts of 303 patients taking 555 medications at time of admission in the six medication classes of interest. A total of 244 (44.0%) of medications were therapeutically interchanged to an approved formulary drug at admission, affecting 64% of the study patients. Among the therapeutically interchanged drugs, we identified 78 (32.0%) suspected medication conversion errors. The discharge medication reconciliation error rate was 11.5% among the 244 therapeutically interchanged medications, compared with 4.2% among the 311 unchanged medications (relative risk [RR] 2.75, 95% confidence interval [CI] 1.45-5.19).
conclusionsTherapeutic interchange was prevalent among hospitalized patients in this study and elevates the risk for potential medication errors during and after hospitalization. Improved electronic systems for managing therapeutic interchange and medication reconciliation may be valuable.
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