Multiple medication use in older patients in post-acute transitional care: a prospective cohort study(1818 Runganga M, Peel NM, Hubbard RE. Multiple medication use in older patients in post-acute transitional care: a prospective cohort study. Clin Interv Aging [Internet]. 2014[cited 2017 Oct 24];(9):1453-62. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4158998/pdf/cia-9-1453.pdf
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2014 Australia |
Prospective Observational n= 351 |
Comprehensive geriatric assessment, performed at admission and discharge, using the InterRAI Home Care assessment tool. Outpatient abstracts were coded using the World Health Organization's Anatomical Therapeutic Chemical (ATC) Classification System. |
Polypharmacy was observed in 46.7%, and hyperpolypharmacy in 39.2% of patients. Increased numbers of medications have been associated with a greater number of chronic conditions, such as Diabetes Mellitus, heart disease, lung disease and dizziness. The most common drugs were analgesics (56.8%) and gastric protectors (52.7%). The most common potentially inappropriate drugs were tertiary tricyclic antidepressants. |
Adverse Drug Events Post-Hospital Discharge in Older Patients: Types, Severity, and Involvement of Beers Criteria Medications(1919 Kanaan AO, Donovan JL, Duchin NP, Field TS, Tjia J, Cutrona SL, et al. Adverse drug events post-hospital discharge in older patients: types, severity, and involvement of beers criteria medications. J Am Geriatr Soc [Internet]. 2013[cited 2017 Oct 20];61(11):1894-99. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4446728/pdf/nihms517947.pdf
https://www.ncbi.nlm.nih.gov/pmc/article...
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2013 United States |
Cross-Sectional Retrospecti ven = 1000 |
Comprehensive analyzes of medical records to identify possible drug-related incidents during the 45-day post-hospital discharge period. |
At least one ADE was identified during the 45-day period in 18.7% of participants. Of the 115 ADEs identified, 35% were considered avoidable. 32% were characterized as severe and 5% as life threatening. More than half of all ADEs occurred within the first 14 days after hospitalization. |
Predictors of medication adherence post-discharge: the impact of patient age, insurance status and prior adherence(2020 Cohen MJ, Shaykevich S, Cawthon C, Kripalani S, Paasche-Orlow MK, Schnipper JL. Predictors of medication adherence post-discharge: the impact of patient age, insurance status and prior adherence. J Hosp Med [Internet]. 2012 [cited 2017 Oct 16];7(6):470-5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3575732/pdf/nihms434410.pdf
https://www.ncbi.nlm.nih.gov/pmc/article...
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2012 United States |
Randomized Controlled Study n = 646 |
Survey of medical records and interview for sociodemographic data collection, cognition, health literacy level, medicine in use, and adherence to medication prior to admission. New telephone interview 30 days post-discharge for application of structured questionnaire to measure the level of adherence to the medication. |
The mean post-discharge adhesion index was 95%. For each increase of 10 years of age, there was an absolute increase of 1% in adhesion. Patients with private insurance were 4.5% less adherent. Health literacy was not an independent predictor of post-discharge adherence. |
Relationship of Health Literacy to Intentionaland Unintentional Non-Adherence of HospitalDischarge Medications(2121 Lindquist LA, Go L, Fleisher JV, Jain N, Friesema E, Baker DW. Relationship of health literacy to intentional and unintentional non-adherence of hospital discharge medications. J Gen Intern Med [Internet]. 2011[cited 2018 Jan 02];27(2):173-8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3270238/pdf/11606_2011_Article_1886.pdf
https://www.ncbi.nlm.nih.gov/pmc/article...
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2011 United States |
Correlational n=254 |
Interviews with patients before and after discharge; application of the S-TOFHLA tool; extraction of data from discharge medical records; and coding of drug discrepancies. |
56% presented a discrepancy between discharge instructions and home use 48 hours post-discharge. Subjects who did not receive guidelines showed no adherence (47.7%) and those oriented were less likely to non-adherence (73.3%). Another common cause of discrepancies was incomplete instructions (39.3%). |
Nurse Identified Hospital to Home Medication Discrepancies: Implications for Improving Transitional Care(2222 Corbett CF, Setter SM, Daratha KB, Neumiller JJ, Wood LD. Nurse Identified Hospital to Home Medication Discrepancies: Implications for Improving Transitional Care. Geriatr Nurs [Internet]. 2010 [cited 2018 Jan 02];31(3):188-96. Available from: https://www.sciencedirect.com/science/article/pii/S0197457210002028
https://www.sciencedirect.com/science/ar...
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2010 United States |
Randomized Prospective n = 101 |
Application of the electronic version of the Medication Discrepancy Tool (MDT). |
94% of participants had at least one drug discrepancy. The contributing causes were related to the patient, with emphasis on non-intentional medication adherence (39.6%), with emphasis on incomplete/inaccurate/illegible discharge instructions (46.5%). |
Drug related problems after discharge from an Australianteaching hospital(2323 Ellitt GR, Engblom E, Aslani P, Westerlund T, Chen TF. Drug related problems after discharge from an Australian teaching hospital. Pharm World Sci [Internet]. 2010 [cited 2018 Jan 02];(32):622-30. Available from: https://link.springer.com/content/pdf/10.1007%2Fs11096-010-9406-9.pdf
https://link.springer.com/content/pdf/10...
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2010 Australia |
Documentary Retrospective Research n = 76 |
Documentary research and data grouping from discharge summary analysis, home drug review reports and home drug review. |
DRPs were identified in 71 patients (93.3%), with 398 problems and an average of 5.6 problems / patient. The most frequent problems were uncertainty about the drug's goal, potential interactions and adverse reactions. |
Adherencia al tratamiento farmacológico en pacientes ancianos tras el alta hospitalaria(2424 Castellano-Muñoz P, Miranda-Ruiz A, Sojo-González G, Perea-Milla E, García-Alegría JJ, Santos-Rubio MD. [Pharmacological treatment adherence by older patients after hospital discharge]. Enferm Clin. 2008;18(3):120-26. Spanish.)
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2008 Spain |
Cross-Sectional Study n = 70 |
Two home interviews (3 and 20 days post-discharge) for the application of a questionnaire containing quantitative and qualitative data (sociodemographic data and related to the use of prescribed drugs). |
85% of the medicines are used incorrectly, mainly more than the prescribed ones (67%). The causes for misuse were forgetfulness and lack of knowledge. The risk factors were: male gender, live with children and more prescribed drugs. |
Relationship of In-Hospital Medication Modifications of Elderly Patients to Postdischarge Medications, Adherence, and Mortality(2525 Mansur N, Weiss A, Beloosesky, Y. Relationship of in-hospital medication modifications of elderly patients to postdischarge medications, adherence, and mortality. Sage J[Internet]. 2008[cited 2018 Jan 02];42(6):783-9. Available from: https://journals.sagepub.com/doi/pdf/10.1345/aph.1L070
https://journals.sagepub.com/doi/pdf/10....
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2008 Israel |
Retrospective Prospective Cohort Study n=212 |
Clinical and demographic data, post-discharge drug modifications, and adherence were prospectively obtained through patient interviews. Modifications of the in-hospital drug regimen were obtained retrospectively through medical records. Professionals were occasionally interviewed to clarify the reasons for drug modifications. |
The rate of modification of the drug regimen was 49.8%. Cognitively normal patients who were admitted with polypharmacy and were discharged home experienced fewer drug modifications. Three months after discharge, 17 patients died and 50 were readmitted. The main risk factors were impaired cognition and chronic disease. |
Continuity and Adherence to Long-Term Drug Treatment by Geriatric Patients after Hospital Discharge(2626 Mansur N, Weiss A, Hoffman A, Gruenewald T, Beloosesky Y. Continuity and adherence to long-term drug treatment by geriatric patients after hospital discharge: a prospective cohort study. Drugs Aging. 2008;25(10):861-70. doi: 10.2165/00002512-200825100-00005 https://doi.org/10.2165/00002512-2008251...
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2008 Israel |
Cohort Prospective n=198 |
Clinical, demographic and drug data were recorded for all patients, applying the Mini-Mental State Examination (MMSE) scale and pre-discharge interview. After one month, the patient, caregiver or doctor were interviewed regarding the extent and reasons for changes in the regimen of medication and adherence to the treatment. |
An average post-discharge month, 36.7% of patient medications had been modified in comparison to the discharge prescription. To improve adherence to the drug regimen, patients should be encouraged to return to health services. |
Posthospital medication discrepancies: prevalence and contributing factors(2727 Coleman EA, Smith JD, Raha D, Min SJ. Posthospital medication discrepancies: prevalence and contributing factors. Arch Intern Med [Internet]. 2005 [cited 2018 Jan 02];165(16):1842-7. Available from: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/486693
https://jamanetwork.com/journals/jamaint...
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2005 United States |
Intervention Research n= 375 |
Application of the Medication DiscrepancyTool (MDT). |
14.1% of the patients presented one or more discrepancies. The discrepancy factors were 50.8% associated with the patient and 49.2% associated to the system. 14.3% of the patients who suffered discrepancies were rehospitalized in 30 days. |