Heckman, Alexander

AbstractBackgroundMedication discrepancies are common between transitions in healthcare and are associated with higher healthcare utilisation and hospital readmission following discharge. Medication reconciliation is a key intervention to reduce medication list discrepancy. The transition between discharge and first outpatient appointment is critical for patient recovery. The proportion of medication discrepancies during this interval is not well characterised.AimThe aim of this study was to evaluate the accuracy of patients’ medication list between discharge from hospital or emergency department to first outpatient follow‐up with their primary care physician.MethodsA cross‐sectional observational study was performed between November 2015 and May 2016. A 10‐question survey was designed to identify potential areas of inaccuracies in the medication lists.ResultsIn all, 106 patients completed the survey, of whom 67.9% (n = 72) had complete data. Eighty per cent of patients (n = 85) had a provider review their medication list prior to discharge. At the time of follow‐up, 22.6% (n = 28) were not taking the listed medications; of this cohort, 35% (n = 8) had a physician instruct them to stop taking medication. Six per cent of patients (n = 6) reported incorrect medication doses.ConclusionMedication discrepancies occur in the transition from hospital discharge to first follow‐up. This poses a threat to patient safety. A standardised process of medication review is critical to prevent such errors.