Abstract
Background
Hospital admission and discharge are weakness points in the transition of care.
Objective
To lower the risk of errors and improve medication information transfer to primary care physician (PCP), we conducted an experimental study using a structured medication reconciliation form (SMRF) in an Acute Care for Elders unit.
Results
1242 drugs of 173 patients were reconciliated at admission, optimized during the stay, and transmitted via the SMRF to the 143 corresponding PCPs. While the optimization led to 779 adaptations from admission to discharge, of which 39.0% were omissions, exposure to polypharmacy was reduced from 83.2 to 74.6% (P < 0.05). One-month post-discharge, with an answer rate of 62.2% among PCPs, the adherence to recommendations was high (85.0%) and the exposure to polypharmacy was further decreased (67.7%; P < 0.05).
Conclusion
These results provide elements to consider SMRF as an example of good practice for which the impact should be analyzed at larger scale.
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(adapted from11). Mr. A. is an 89-year-old man who lives at home with his 10-year younger wife. He is without cognitive impairment, but with limited mobility due to sever polyarthritis. He has been treated for hypertension with three antihypertensive drugs (felodipine, bisoprolol, and hydrochlorothiazide). Because of stable angina pectoris, he receives isosorbide dinitrate, aspirin, and simvastatin. Mr. A.’s blood pressure is 125/70 mmHg when he is in supine position and 105/65 mmHg when upright. This orthostatic hypotension is associated with an increased risk of falls and consecutive fractures. His medical history is also positive for peptic ulcer disease
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CP, CPh and GX have designed the study. JD, CP, CPh, CC, GX, and POL have analyzed the data. JD, CP, GX, CC, CPh, and POL have written the manuscript.
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None of the authors has any conflict of interest to declare.
Ethical approval
The local ethic committee approved this experimental protocol. All procedures performed in studies involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent
An informed consent was obtained from all particpants (eligible patients and PCPs).
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Dumur, J., Chassagne, P., Gbaguidi, X. et al. Using a structured reconciliation medication form improves medication transition from hospital to community care and primary care physicians’ adherence with medication adaptations and recommendations. Eur Geriatr Med 10, 141–146 (2019). https://doi.org/10.1007/s41999-018-0125-4
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DOI: https://doi.org/10.1007/s41999-018-0125-4