ArticleTherapeutic advances in drug safety2019
Frequency of undocumented medication discrepancies in discharge letters after hospitalization of older patients: a clinical record review study.
Article in Therapeutic advances in drug safety, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 32 citations in OpenAlex.
- Trial
- Article
- Pharmacist-led interventions at hospital discharge: a scoping review of studies demonstrating reduced readmission rates.International journal of clinical pharmacy · 2025Article
- Intervention for a correct medication list and medication use in older adults: a non-randomised feasibility study among inpatients and residents during care transitions.International journal of clinical pharmacy · 2024Article
- The Impact of Pharmacist Medication Reviews on Geriatric Patients: A Scoping Review.Korean journal of family medicine · 2024Article
- Health professionals' experience and perceived obstacles with managing patients' medication information in Norway: cross-sectional survey.BMC health services research · 2024Article
- Effectiveness of Clinical Pharmacists-Led Medication Reconciliation to Prevent Medication Discrepancies in Hospitalized Patients: A Non-Randomized Controlled Trial.Integrated pharmacy research & practice · 2024Article
- The complexities of communication at hospital discharge of older patients: a qualitative study of healthcare professionals' views.BMC health services research · 2023Article
- The value of incorporating patient-consulted medication reconciliation in influencing drug-related actions in the outpatient rheumatology setting.BMC health services research · 2022Observational
- Article
- Risk factors associated with unintentional medication discrepancies at admission in an internal medicine department.Internal and emergency medicine · 2021Observational
- Causes of discrepancies between medications listed in the national electronic prescribing system and patients' actual use of medications.Basic & clinical pharmacology & toxicology · 2021Article
- Pharmacist-led medication reconciliation on admission to an acute psychiatric hospital unit.Pharmacy practiceArticle
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Transitions of care may result in medication errors, when information about a patient's medications is not communicated sufficiently. In this clinical record review study, we aimed to evaluate the frequency of undocumented medication discrepancies at discharge from hospital and evaluate which patient characteristics could be associated with undocumented medication discrepancies. Preadmission medication lists were compared against the medication list in the discharge letters, taking into account medication changes documented in the patient record throughout the inpatient stay and in the discharge summary. Out of 200 patients, 174 (87%) were affected by at least one undocumented medication discrepancy, mostly for regular medication. Of the 1972 medications used, 744 (38%) medications were changed without documentation in the patient record, the majority being over-the-counter supplements and herbal medications. Polypharmacy at admission and discharge was associated with increased undocumented medication discrepancies. This study indicates a lack of medication reconciliation during inpatient stay. Correct and complete medication lists at admission and discharge may resolve many of these discrepancies, supporting patient safety at transitions of care.
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