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Completeness of patient records in community pharmacies post-discharge after in-patient medication reconciliation: a before-after study

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Abstract

Background Transfer of discharge medication related information to community pharmacies could improve continuity of care. This requires for community pharmacies to accurately update their patient records when new information is transferred. An instruction manual that specifies how to document information regarding medication changes and clinical information (i.e. allergies/contraindications) could support community pharmacies. Objective To explore the effect of instruction manuals sent to community pharmacies on completeness of their patient records. Setting A before–after study was performed (July 2009–August 2010) in the St Lucas Andreas Hospital, a general teaching hospital in Amsterdam, The Netherlands. Methods Patients discharged from the cardiology and respiratory ward were included consecutively. The intervention consisted of a training session for community pharmacies regarding documentation problems and faxing an instruction manual to community pharmacies specifying how to document discharge information in their information system. Usual care consisted of faxing a discharge medication overview to community pharmacies without additional instructions. Two weeks after discharge the medication records of community pharmacies were collected by fax. These were compared with the initial discharge overviews regarding completeness of medication changes (i.e. explicit explanation that medication had been changed) and clinical information documentation. Main outcome measure Outcomes were the number and percentage of completely documented medication changes (either needing to be dispensed or not) and clinical information items. The sample size was calculated at 107 patients per measurement period. Multivariable logistic regression was used for analysis. Results Two hundred and eighteen patients (112 before–106 after) were included. Completeness of medication changes documentation increased marginally after the intervention (46.6 vs 56.3 %, adjusted Odds Ratio 1.4 [95 % confidence interval 1.07–1.83]). Documentation increased when medication was actually dispensed by the community pharmacy. No significant improvements were seen for allergy and contraindication documentation. Conclusion The intervention is insufficient to increase the completeness of documentation by community pharmacies as marginal improvements were achieved. Future studies should evaluate whether electronic infrastructures may help in achieving updated medication records to improve continuity of pharmaceutical care.

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Acknowledgments

We would like to express our gratitude to the pharmaceutical consultants, the patients involved in this study, Inge van den Boom (SOZA, i.e. institute for information technology), Bob de Dood (Pharmaceutical Bureau Amsterdam), all community pharmacies that cooperated in this study and the software providers for their efforts and cooperation in this study.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Conflicts of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Hospital Pharmacy, Sint Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands

    Fatma Karapinar-Çarkıt, Ben R. L. van Breukelen & Marjo J. A. Janssen

  2. Department of Medication Surveillance, Health Base, De Molen 43, 3994 DA, Houten, The Netherlands

    Sander D. Borgsteede

  3. SIR Institute for Pharmacy Practice and Policy, Theda mansholtstraat 5b, 2331 JE, Leiden, The Netherlands

    Sander D. Borgsteede

  4. Department of Clinical Pharmacy, University Medical Centre Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands

    Antoine C. G. Egberts

  5. Utrecht Institute for Pharmaceutical Sciences, Division Pharmacoepidemiology and Clinical Pharmacology, Faculty of Science, Utrecht University, PO Box 80082, 3508 TB, Utrecht, The Netherlands

    Antoine C. G. Egberts

  6. Department of Hospital Pharmacy, Erasmus MC, Room Nc-212, PO Box 2040, 3000 CA, Rotterdam, The Netherlands

    Patricia M. L. A. van den Bemt

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  1. Fatma Karapinar-Çarkıt
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  2. Ben R. L. van Breukelen
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  3. Sander D. Borgsteede
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  4. Marjo J. A. Janssen
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  5. Antoine C. G. Egberts
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  6. Patricia M. L. A. van den Bemt
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Correspondence to Fatma Karapinar-Çarkıt.

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Karapinar-Çarkıt, F., van Breukelen, B.R.L., Borgsteede, S.D. et al. Completeness of patient records in community pharmacies post-discharge after in-patient medication reconciliation: a before-after study. Int J Clin Pharm 36, 807–814 (2014). https://doi.org/10.1007/s11096-014-9965-2

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  • DOI: https://doi.org/10.1007/s11096-014-9965-2

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