title: Medication Discrepancies and Associated Risk Factors Identified in Home Health patients.
abstract: Medication discrepancies can place patients at increased risk for adverse drug events. We sought to determine the frequency, type, and reason for medication discrepancies in patients receiving home healthcare following hospital discharge. We conducted a retrospective, observational study of adults discharged from an academic medical center who received home healthcare following hospital discharge from one affiliated home healthcare agency. Medication discrepancies were identified by comparing the hospital discharge medication list to what the patient was taking at the first home healthcare visit. Almost all patients (66/70, 94%) had at least one medication discrepancy. The median number of discrepancies per patient was 5. Nearly half of the discrepancies were omissions (46%), in which the patient was not taking a medication on the discharge medication list. Increased age was significantly associated with fewer medication discrepancies overall (IRR = 0.99, p < 0.05). Higher health literacy was associated with more omissions (IRR = 1.85, p < 0.05).
authors.affiliation: Jennifer Hale, PharmD, MPA, is a Pediatric Pharmacy Resident, Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, Tennessee. Erin B. Neal, PharmD, BCPS, is a Clinical Pharmacist, Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, Tennessee. Amy Myers, PharmD, BCPS, is a Clinical Pharmacist, Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, Tennessee. Kelly H.S. Wright, MA, is a Program Coordinator, Section of Hospital Medicine, Vanderbilt University Medical Center, Nashville, Tennessee. Julia Triplett, MSN, MBA, NE-BC, is the Director of Staff Development, Vanderbilt Home Care Services, Inc., Nashville, Tennessee. Laura Beth Brown, MSN, RN, is the President, Vanderbilt Home Care Services, Inc., Nashville, Tennessee. Sunil Kripalani, MD, MSc, is an Associate Professor of Medicine, Chief Section of Hospital Medicine, Center for Clinical Quality and Implementation Research, Vanderbilt University Medical Center, Nashville, Tennessee. Amanda S. Mixon, MD, MS, MSPH, is an Assistant Professor of Medicine, GRECC, Department of Veterans Affairs, Tennessee Valley Healthcare System, and Section of Hospital Medicine, Center for Clinical Quality and Implementation Research, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hale
authors.forename: Erin B
authors.initials: EB
authors.lastname: Neal
authors.forename: Amy
authors.initials: A
authors.lastname: Myers
authors.forename: Kelly H S
authors.initials: KH
authors.lastname: Wright
authors.forename: Julia
authors.initials: J
authors.lastname: Triplett
authors.forename: Laura Beth
authors.initials: LB
authors.lastname: Brown
authors.forename: Sunil
authors.initials: S
authors.lastname: Kripalani
authors.forename: Amanda S
authors.initials: AS
authors.lastname: Mixon
mesh_terms: D000328:Adult; D000368:Aged; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000517:prevention & control*; D059065:Medication Reconciliation / Q000706:statistics & numerical data*; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D063868:Patient Outcome Assessment; D012189:Retrospective Studies; D012307:Risk Factors; D012646:Self Administration / Q000706:statistics & numerical data