title: Utilizing community pharmacy dispensing records to disclose errors in hospital admission drug charts.
abstract: OBJECTIVE
  To identify and resolve discrepancies in admission medication histories, utilizing community pharmacy dispensing data, in newly hospitalized patients and investigate the relationship between unresolved discrepancies and length of hospital stay.
  
  
  METHODS
  Eligible patients (2 or more chronic conditions, 3 or more chronic medications and aged over 50 years) were randomized to the intervention or control group. Within 24 h of admission, the patient's nominated community pharmacy was contacted, a 6-month dispensing history obtained, patient was interviewed and a current medication list compiled. This was compared with the hospital drug chart. Discrepancies for the intervention group were discussed with the attending doctor. Subsequent resolution of discrepancies was assessed for all patients.
  
  
  RESULTS
  487 patients were included (203 intervention, 284 control). Approximately 66% of all patients had at least 1 discrepancy between their reconciled list of medications and their initial drug chart, with no significant difference between the groups. Significantly more intervention patients had at least 1 discrepancy resolved in the first 48 h than control patients (intervention 78.1%; control 36.5%; p < 0.0001). A weak correlation was found between the number of discrepancies not acted on and length of hospital stay (Spearman Rho = 0.1, n = 487, p < 0.01).
  
  
  CONCLUSIONS
  Errors in admission medication histories are common and potentially lead to an increased length of stay. The provision of a 6-month community pharmacy dispensing history at the time of hospital admission is an important addition to ensure an accurate medication chart is compiled.
authors: Tasmanian School of Pharmacy, University of Tasmania, Hobart.
authors: Anna J
authors: AJ
authors: Tompson
authors: Gregory M
authors: GM
authors: Peterson
authors: Shane L
authors: SL
authors: Jackson
authors: Jeffrey D
authors: JD
authors: Hughes
authors: Kenneth
authors: K
authors: Raymond
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D016009:Chi-Square Distribution; D003157:Community Pharmacy Services / Q000706:statistics & numerical data*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data*; D008508:Medication Errors / Q000517:prevention & control / Q000706:statistics & numerical data*; D059065:Medication Reconciliation / Q000706:statistics & numerical data*; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D019338:Polypharmacy; D013997:Time Factors