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

2014 ◽  
Vol 36 (4) ◽  
pp. 807-814 ◽  
Author(s):  
Fatma Karapinar-Çarkıt ◽  
Ben R. L. van Breukelen ◽  
Sander D. Borgsteede ◽  
Marjo J. A. Janssen ◽  
Antoine C. G. Egberts ◽  
...  
2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Mohamed Abouelazayem ◽  
Raluca Belchita

Abstract Aim To review the new referrals to the Upper GI surgery clinic for appropriateness, investigations requested, and waiting times and to identify potential pathways to reduce waiting times and improve the patient experience. Method Patients who attended the UGI clinic over 2 months period were identified. Data were collected from GP referrals and Electronic Patient Records. Follow up, post-discharge appointments, and Did Not Attends were excluded. Data collected included time from referral to first clinic, symptoms, investigations requested, suitability for a pathway, and appropriateness of referral. A first clinic outcome was concluded from reading the GP referral, there were 5 outcomes to choose from; direct to another specialty, discharge back to GP, clinic, surgery, pre-investigate and clinic. Results 147 referrals were analysed. The average waiting time from referral to the first clinic was 51 days (range 7-119 days). 73% of the referrals were GP referrals and 27% from other specialties. The most common referral was for gallstones and the most common 2 outcomes were Pre-investigate and surgery. Conclusion Most of the investigations and outcomes suggested from the project were the same as those from clinic letters. The following pathways can be developed to cut waiting times and costs for the trust:


2020 ◽  
Vol 49 (4) ◽  
pp. 558-569 ◽  
Author(s):  
Justine Tomlinson ◽  
V-Lin Cheong ◽  
Beth Fylan ◽  
Jonathan Silcock ◽  
Heather Smith ◽  
...  

Abstract Background medication-related problems occur frequently when older patients are discharged from hospital. Interventions to support medication use have been developed; however, their effectiveness in older populations are unknown. This review evaluates interventions that support successful transitions of care through enhanced medication continuity. Methods a database search for randomised controlled trials was conducted. Selection criteria included mean participant age of 65 years and older, intervention delivered during hospital stay or following recent discharge and including activities that support medication continuity. Primary outcome of interest was hospital readmission. Secondary outcomes related to the safe use of medication and quality of life. Outcomes were pooled by random-effects meta-analysis where possible. Results twenty-four studies (total participants = 17,664) describing activities delivered at multiple time points were included. Interventions that bridged the transition for up to 90 days were more likely to support successful transitions. The meta-analysis, stratified by intervention component, demonstrated that self-management activities (RR 0.81 [0.74, 0.89]), telephone follow-up (RR 0.84 [0.73, 0.97]) and medication reconciliation (RR 0.88 [0.81, 0.96]) were statistically associated with reduced hospital readmissions. Conclusion our results suggest that interventions that best support older patients’ medication continuity are those that bridge transitions; these also have the greatest impact on reducing hospital readmission. Interventions that included self-management, telephone follow-up and medication reconciliation activities were most likely to be effective; however, further research needs to identify how to meaningfully engage with patients and caregivers to best support post-discharge medication continuity. Limitations included high subjectivity of intervention coding, study heterogeneity and resource restrictions.


2019 ◽  
Vol 8 (4) ◽  
pp. 10
Author(s):  
Nathan W. Carroll ◽  
Reena Joseph ◽  
Neeraj Puro

Unplanned readmissions pose a tremendous burden on patients, providers, and payers.  A significant proportion of readmissions are medication-related.  Despite the availability of literature regarding hospital-level strategies to reduce readmissions, little has been written about strategies aimed at medication-related readmissions.  We sought to identify successful readmission reduction strategies by performing a scoping literature review of research published between 2000 and 2017.  We identified 21 studies that met our inclusion criteria.  From these studies, we identified 7 components frequently employed as a part of interventions to reduce medication-related readmissions: discharge planning, discharge education, post-discharge telephone calls, the use of a professional coordinator with clinical training to administer the intervention, patient education efforts, provider training efforts, and medication reconciliation.  Thirty-eight percent of all the interventions identified were associated with a statistically significant reduction in readmissions.  Of the 7 common intervention components we identified, none were consistently associated with intervention success in the full sample.  However, interventions implemented by inpatient hospitals, in particular academic medical centers, had a higher success rate than interventions implemented by other providers.   We examined a subsample of larger studies and found that discharge planning and medication reconciliation components were included in most of the successful interventions.  Future research should look beyond simply identifying components included in an intervention and should instead seek to identify contextual factors that enable or inhibit the success of these components.  Research examining discharge planning and medication reconciliation efforts will be particularly important.


2014 ◽  
Vol 17 (3) ◽  
pp. A152
Author(s):  
A.R. Harrington ◽  
K. Calabro ◽  
K. Boesen ◽  
T.L. Warholak

2018 ◽  
Vol 31 (10) ◽  
pp. 1790-1805 ◽  
Author(s):  
Victoria C. Liu ◽  
Insaf Mohammad ◽  
Bibban B. Deol ◽  
Ann Balarezo ◽  
Lili Deng ◽  
...  

Objectives: This study aimed to evaluate hospital utilization and characterize interventions of pharmacist-led telephonic post-discharge medication reconciliation. Method: A retrospective analysis was conducted, including 833 index events in 586 geriatric patients receiving the intervention. Medicare claims were used to capture 30-day hospital utilization (admission to the emergency department, observation unit, or inpatient hospitalization) following discharge from any of these locations. Medication-related interventions were described. Results: Hospital utilization within 30 days after discharge from any location was greater for patients receiving usual care compared with the intervention (32.5% vs. 22.2%; odds ratio [OR] = 1.69, 95% confidence interval [CI] = [1.06, 2.68]). Inpatient admission within 30 days after discharge from any location was greater for those receiving usual care (14.7% vs. 6.4%; OR = 2.54, 95% CI = [1.18, 5.44]). At least one medication-related problem was identified and addressed in 89.8% of patients receiving the intervention. Discussion: A telephonic post-discharge medication reconciliation program can lead to reduction in hospital utilization in a geriatric population.


2010 ◽  
Vol 01 (04) ◽  
pp. 442-461 ◽  
Author(s):  
L.R. Waitman ◽  
S.H. Brown ◽  
P.J. Porcelli

SummaryMedication reconciliation was developed to reduce medical mistakes and injuries through a process of creating and comparing a current medication list from independent patient information sources, and resolving discrepancies. The structure and clinician assignments of medication reconciliation varies between institutions, but usually includes physicians, nurses and pharmacists. The Joint Commission has recognized the value of medication reconciliation and mandated implementation in 2006; however, a variety of issues have prevented simple, easy, and universal implementation. This review references issues related to the development and the implementation of medication reconciliation including: – the need of a system or standard for accurate drug identification to create a definitive ‘gold standard’ patient medication list, – identifying stakeholders of medication reconciliation within the institution and contrasting staff interest and participation with institutional resources, – observations and opportunities of integrating medication reconciliation with the electronic patient health record, and – summarizing a series of institutions experiences developing and implementing medication reconciliation. Last, as medication reconciliation becomes a regular process within medical centers, key concepts for effective implementation are discussed.


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