title: Gaps in continuity of medication management during the transition from hospital to residential care: an observational study (MedGap Study).
abstract: OBJECTIVE
  To assess continuity of medication management during transition from hospital to residential care facilities (RCFs).
  
  
  METHODS
  Telephone interviews with RCF staff were performed 24 hours after patient transfer to determine the proportion of patients with: missed or significantly delayed doses; RCF medication chart not written/updated in time for the first dose; suitably packed medications not available for the first dose; and RCF medication chart written/updated by a locum doctor. Retrospective audit was used to identify discharge summary discrepancies.
  
  
  RESULTS
  Seventy-five doses for 37/202 (18.3%) patients were missed or significantly delayed in the 24 hours after discharge. One hundred and twenty-five (61.9%) patients did not have their medication chart written/updated and 77 (38.1%) did not have suitably packed medications available for the first dose. Locum doctors wrote RCF medication charts for 66 (32.7%) patients. One hundred and ninety-seven of 392 (50.3%) changes to regularly scheduled medications were communicated.
  
  
  CONCLUSIONS
  Strategies are needed to address gaps in the continuity of medication management.
authors.affiliation: Pharmacy Department, Austin Health, Melbourne, Victoria, Australia. rohan.elliott@austin.org.au
authors.forename: Rohan A
authors.initials: RA
authors.lastname: Elliott
authors.forename: Tim
authors.initials: T
authors.lastname: Tran
authors.forename: Simone E
authors.initials: SE
authors.lastname: Taylor
authors.forename: Penelope A
authors.initials: PA
authors.lastname: Harvey
authors.forename: Mary K
authors.initials: MK
authors.lastname: Belfrage
authors.forename: Rhonda J
authors.initials: RJ
authors.lastname: Jennings
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Marriott
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003266:Continuity of Patient Care / Q000458:organization & administration*; D005260:Female; D006761:Hospitals / Q000592:standards*; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000517:prevention & control*; D010351:Patient Discharge; D010360:Patient Transfer / Q000458:organization & administration*; D012114:Residential Treatment / Q000458:organization & administration*; D012189:Retrospective Studies