FACTORS RELATED TO THE REDUCTION OF MEDICATION DISCREPANCIES AT TRANSITION OF CARE: A SYSTEMATIC REVIEW
Background: Adverse drug events (ADE) are a leading cause of injury and death within health care systems around the world. Up to 67% of patients’ prescription medication histories recorded on admission to hospital have one or more errors and 30 – 80% of patients have a discrepancy between the medicines ordered in hospital and those they were taking at home. This study aims to systematically evaluate the available literature on the medication history records as a quality improvement in reducing medication discrepancies during the transition of care.
Methods: This study was used systematic review which performed according to the PRISMA method. The search included articles were obtained through databases: MEDLINE (1946), EMBASE (1966), CINAHL (1937) and PubMed (1946). Some of the key words or Medical Subject Heading (MeSH) terms used in the search were: “transition of care,” “medication discrepancies,” “medication errors,” “patient safety,” “medication history,” “patient admission,” “patient discharge,” “patient transfer,” and “hospital”. Only studies published in English were included. Exploring literature was focused on the articles published from 2009 to 2019.
Results: Initially, a total of 162 potentially relevant articles were obtained. After screening tittle and reviewing abstracts, 14 full text were assessed for eligibility. Of the 10 articles met all inclusion criteria, 5 studies were randomized controlled trials, 2 quasi-experimental studies, 1 cohort study, and 2 qualitative studies with quantitative approaches. All studies found that involving best possible medication history in identifying medication discrepancies and communicating this information affected medication discrepancies in the medical record. Conclusions: The available literature such as lack of well-designed studies precluded us from concluding that no effect exists. Medication reconciliation supported by information technology was an important tool for minimizing the percentage of medications with unintentional discrepancies
World Health Organization. Transitions of Care: Technical Series on Safer Primary Care, 2016 [online] Available at https://apps.who.int/iris/bitstream/handle/10665/252272/9789241511599- eng.pdf;jsessionid=0A8E4ED8664EF915A144B19820D75F72?sequence=1 (last accessed 8 April 2019)
World Health Organization. Action on patient safety – high 5 s, 2014 [online]. Available at http://www.who.int/patientsafety/ implementation/solutions/high5s/en/ (last accessed 3 April 2019)
Marcotte L, Kirtane J, Lynn J, et al. Integrating health information technology to achieve seamless care transitions. J Patient Saf 2015; 11(4):185-90.
Greenwald JL, Denham CR, Jack BW. The hospital discharge: A review of high risk care transition with highlights of a reengineered discharge process. J Patient Saf 2007; 3(2):97-106
Sullivan C et al. Medication reconciliation in the acute care setting: opportunity and challenge for nursing. J Nurse Care Qual 2005; 20(2):95-98.
Vira T, Colquhoun M, Etchells EE. Reconciliable differences: correcting medication errors at hospital admission and discharge. Qual Saf Healthcare 2006; 0001: 1-6.
Cornish PL, Knowles SR, Marcheso R, Tam V, Shadowiz S, Juurlink DN, Etchells EE. Unintended medication discrepancies at the time of hospital admission. Arch Intern Med. 2005; 1265:424-429.
NICE NPSA Guidance: Technical patient solutions for medicines reconciliation on admission of adults to hospital. http://www.nice.org.uk/guidance/index.jsp?action=byID&o=11897
Institute for Healthcare Improvement. How-to guide: prevent adverse drug events (medication reconciliation), 2011. Available at http://www.ihi.org/resources/Pages/Tools/ HowtoGuidePreventAdverseDrugEvents.aspx (last accessed 9 March 2019).
Neumiller JJ, et al. Medication discrepancies and potential Adverse Drug Events During Transfer of Care from Hospital to Home. AHRQ Publication no 17-0017. August 2017
Moher D, Tetzlaff J, Altman DG, The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med. 2009;6:e1000097.
Thompson-Moore N, Liebl MG. Health care system vulnerabilities: understanding the root causes of patient harm. Am J Health Syst Pharm 2012;69:431–6.
Lee JY, Leblanc K, Fernandes OA et al. Medication reconciliation during internal hospital transfer and impact of computerized prescriber order entry. Ann Pharmacother. 2010; 44:1887-95.
Marvin V, et al. Applying quality improvement methods to address gaps in medicines reconciliation at transfer of care from an acute UK hospital. BMJ Open 2016;6:e010230
Drovandi A, et al. A systematic review of clinical pharmacist interventions in paediatric hospital patients. European Jornal of paediatrics 177:1139-1148. June 2018
Huber T, et al. 2017. Implementation of an IT-guided checklist to improve the quality of medication history record at hospital admission. Int J Clin Pharm (2017) 39:1312-1319
Desnoyer A, et al. PIM-check: Development of an international prescription-screening checklist designed by a Delphi method for internal medicine patients. BMJ Open; London Vol.7, Iss.7. 2017
Becerra-Camargo J, et al. 2015. The effect on potential adverse drug events of a pharmacist-acquired medication history in an emergency department: a multicenter, double blind, randomized, controlled, parallel-group study. BMC Health Service Research (2015) 15:337
Tamiru A, et al. Magnitude and factors associated with medication discrepancies identified through medication reconciliation at care transitions of tertiary hospital in eastern Ethiopia. BMC Research Note (2018) 11:554
Hawes EM, et al. Impact of an Outpatient Pharmacist Intervention on Medication Discrepancies and Health Care Resource Utilization in Posthospitalization Care Transitions. Journal of Primary Care & Community Health 2014, Vol 5(1) 14-18
Schipper JL, et al. 2009. Effect of an Electronic Medication Reconciliation Application and Process Redesign on Potential Adverse Drug Events. American Medical Association. Arch Intern Med. 2009
Farley TM, et al, 2016. Effet of Clinical Pharmacist Intervention on Medication Discrepancies Following Hospital Discharge. NIH Public Access. Int J Clin Pharm. 2014
Kerstenetzky L, et al. Improving Medication Information Transfer between Hospitals, Skilled-Nursing Facilities, and Long-Term-Care Pharmacies for Hospital Discharge Transitions of Care: A Targeted Needs Assessment Using the Intervention Mapping Framework. Res Social Adm Pharm. 2018 February ; 14(2): 138-145. Doi:10.1016/j.sapharm.2016.12.013
Boockvar KS, et al. Electronic Health Records and Adverse Drug Events after Patient Transfer. Qual Saf Health Care. 2010 October ; 19(5): 1 – 5. Doi:10.1136/qshc.2009.033050
Azzi M, et al. Medication Safety: an audit of medication discrepancies in transferring type 2 diabetes mellitus (T2DM) patients from Australian primary care to tertiary ambulatory care. International Journal for Quality in Health Care 2014; Volume 26, Number 4: pp.397-403