ArticleDrugs - real world outcomes2020
Medication Discrepancies in Discharge Summaries and Associated Risk Factors for Elderly Patients with Many Drugs.
Article in Drugs - real world outcomes, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed.
- The impact of clinical pharmacist-physician communication on reducing drug-related problems: a mixed study design in a tertiary teaching Hospital in Xinjiang, China.BMC health services research · 2022Trial
- Trial
- An Underused Competence: Clinical Pharmacists' Experiences of Writing Referrals in Transitions of Care.Pharmacy (Basel, Switzerland) · 2026Article
- Article
- Artificial Intelligence-Assisted Error Detection in Complex Clinical Documentation: Leveraging Large Language Models to Enhance Patient Safety in Oncology.JCO clinical cancer informatics · 2026Article
- Article
- Analysis of a medication discrepancy management platform in reducing medication discrepancy and influencing factors among elderly patients with polypharmacy.European journal of clinical pharmacology · 2025Article
- Article
- How prone are Swedish general practitioners to perform medication reconciliation? A theory-based survey study.Therapeutic advances in drug safety · 2025Article
- Perception of Medication Safety-Related Behaviors Among Different Age Groups: Web-Based Cross-Sectional Study.Interactive journal of medical research · 2024Article
- Impact of pharmacist-led discharge medication reconciliation on error and patient harm prevention at a large academic medical center.Journal of the American College of Clinical Pharmacy : JACCP · 2024Article
- 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
- Continuation of Buprenorphine During Hospitalization and Subsequent Retention in Therapy: an Observational Study in Veterans Administration Hospitals.Journal of general internal medicine · 2024Observational
- Towards Inpatient Discharge Summary Automation via Large Language Models: A Multidimensional Evaluation with a HIPAA-Compliant Instance of GPT-4o and Clinical Expert Assessment.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2024Article
- Exploring the Roles of Nurses in Medication Reconciliation for Older Adults at Hospital Discharge: A Narrative Approach.Clinical interventions in aging · 2024Article
- The Impact of Real-Time Documentation of In-Hospital Medication Changes on Preventing Undocumented Discrepancies at Discharge and Improving Physician-Pharmacist Communication: A Retrospective Cohort Study and Survey.Journal of multidisciplinary healthcare · 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
- Effect of educational intervention on medication reconciliation practice of hospital pharmacists in a developing country - A non-randomised controlled trial.BMC medical education · 2023Article
- The complexities of communication at hospital discharge of older patients: a qualitative study of healthcare professionals' views.BMC health services research · 2023Article
- Study Protocol for the Evaluation of Multidisciplinary Medication Reconciliation Service in Adult Patients Undergoing Thoracic and Cardiovascular Surgery (The MERITS Study): A Single-Center Controlled before-and-after Study.Healthcare (Basel, Switzerland) · 2023Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveElderly patients are at high risk for medication errors in care transitions. The discharge summary aims to counteract drug-related problems due to insufficient information transfer in care transitions, hence the accuracy of its medication information is of utmost importance. The purpose of this study was to describe the medication discrepancy rate and associated risk factors in discharge summaries for elderly patients.
methodsPharmacists collected random samples of discharge summaries from ten hospitals in southern Sweden. Medication discrepancies, organisational, and patient- and care-specific factors were noted. Patients aged ≥ 75 years with five or more drugs were further included. Descriptive and logistic regression analyses were performed.
resultsDischarge summaries for a total of 933 patients were included. Average age was 83.1 years, and 515 patients (55%) were women. Medication discrepancies were noted for 353 patients (38%) (mean 0.87 discrepancies per discharged patient, 95% confidence interval 0.76-0.98). Unintentional addition of a drug was the most common discrepancy type. Central nervous system drugs/analgesics were most commonly affected. Major risk factors for the presence of discrepancies were multi-dose drug dispensing (adjusted odds ratio 3.42, 95% confidence interval 2.48-4.74), an increasing number of drugs in the discharge summary (adjusted odds ratio 1.09, 95% confidence interval 1.05-1.13) and discharge from departments of surgery (adjusted odds ratio 2.96, 95% confidence interval 1.55-5.66). By contrast, an increasing number of drug changes reduced the odds of a discrepancy (adjusted odds ratio 0.93, 95% confidence interval 0.88-0.99).
conclusionsMedication discrepancies were common. In addition, we identified certain circumstances in which greater vigilance may be of considerable value for increased medication safety for elderly patients in care transitions.
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