Continuity of long-term medication use after surgical hospital stay.
OBJECTIVE
To investigate changes in long-term medication during the transfer between surgical hospital and primary care. To examine differences in defined daily doses (DDDs) versus real prescribed daily doses (PDDs).


METHODS
During a 15-month period, patients from three surgical wards in a university-based teaching hospital were asked about their medication at admission (T1), at discharge (T2), and 3 months after discharge (T3). Complete data were obtained for 299 patients (169 women, 130 men; mean age 69.5 years). Both DDD and PDD were calculated for each drug. Analysis of data was performed using a relational database.


RESULTS
Patients took 3.6 drugs (+/-2.2) at T1, 5 (+/-2.4) at T2, and 3.8 (+/-3.1) at T3. After surgical intervention, a discontinuation of analgesic, anti-rheumatic, and thyroid medication was observed frequently (35% of discontinued drugs at T2). We found more drug alterations at T3 than at T2 (263 versus 87). Family doctors mostly changed medications prescribed for the cardiovascular system (22% of all cardiovascular agents were discontinued and/or started at T3). We could not determine those changes to be methodical. The total of PDDs and DDDs did not differ, but the mean PDDs of statins and beta-blocking agents were significantly below the DDDs (P<0.005).


CONCLUSIONS
The observed changes in medication after hospitalization can be only partially attributed to a successful surgical intervention and to the hospital stay. Those alterations seemed not to be initiated by the intention of saving costs.
Hach
I
I
Medical Faculty, Institute of Clinical Pharmacology, Technical University of Dresden, Fiedlerstr 27, 01307, Dresden, Germany. isabel.hach@mailbox.tu-dresden.de
Maywald
U
U
Meusel
D
D
König
J U
JU
Kirch
W
W
D000368:Aged; D003266:Continuity of Patient Care; D011307:Drug Prescriptions; D005260:Female; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D007902:Length of Stay; D008297:Male; D008499:Medical Records; D010351:Patient Discharge; D010818:Practice Patterns, Physicians'; D013514:Surgical Procedures, Operative; D013997:Time Factors