Medication discrepancies at care transitions and associated factors among adult inpatients discharged from Auckland City Hospital

• At: PPR SIG 2021 (2021)
• Type: Digital
• By: MOHAMMED, Mohammed (University of Auckland, New Zealand)
• Co-author(s): Mohammed Mohammed1, Nataly Martini1, Hannah Rogers1,2, Enoch Boakye-Yiadom1, Wilson Cowie1, Kieran Grant1, Amy Chan1,2 1. University of Auckland, School of Pharmacy, Auckland, New Zealand 2.Pharmacy Department, Auckland District Health Board, Auckland, New Zealand
  
• Abstract:

  Introduction

  Medication discrepancies are common during care transitions. About 50% of medication errors and 20% adverse events are due to miscommunication at interfaces of care. There is a paucity of data regarding the prevalence, characteristics and predictors of medication discrepancies occurring at care transitions in New Zealand.

  Objectives

  This study aimed to describe medication discrepancies and associated factors among adult patients discharged from Auckland City Hospital between August and November 2019

  Methods

  A retrospective review of medical records of eligible patients was performed between June and September 2020. Patients were included if they were ≥ 18 years old, had at least one medication on their hospital chart or discharge summary and were discharged from general surgical or general medical wards. Data on sociodemographic, medication and hospital services information were collected. Medication information on medicine charts and discharge summaries were compared. Discrepancies were documented as intentional or unintentional. Unintentional discrepancies were classified as omissions, additions, substitutions and changes of dose, frequency or administration route. Multivariable logistic regression analyses were used to identify predictors of medication discrepancies.

  Results

  Of 776 patients (447 medical and 329 surgical) included in the study, 62.67% had at least one unintentional discrepancy. Omission of medication was the most common type of discrepancy (77.66%). Nervous system medications were the most frequently involved class of medicine. Polypharmacy (Adjusted odds ratio/AOR 2.70; CI 1.70, 4.29), length of hospital stay over 48 hours (AOR 2.58, CI 1.82, 3.66) and discharge from a surgical ward (AOR 4.77; CI 3.34, 6.79) were associated with higher likelihood of discrepancies.

  Conclusion

  The prevalence of unintentional discrepancies was high in the study population. Polypharmacy, longer hospital stay and discharge from surgical ward were common predisposing factors. Future research should focus on evaluation of severity of discrepancies, and the impact of medication reconciliation at discharge on medication errors and patient safety outcomes.