title: Discrepancies between in-home interviews and electronic medical records on regularly used drugs among home care clients.
abstract: OBJECTIVE
  To compare discrepancies between in-home interviews and electronic medical records (EMRs) on regularly used prescription drugs among older home care clients.
  
  
  METHODS
  The participants were home care clients aged 75 years or older living in three Finnish municipalities. In-home interview data on regular prescription drug use from 276 home care clients were compared with EMRs. Agreement between the in-home interview data and EMRs was assessed using Cohen's kappa.
  
  
  RESULTS
  A majority (83%, n = 229) of the home care clients had discrepancies between in-home interview data and EMRs, and 40% had discrepancies that could clinically compromise their treatment. Living with a spouse or other family member, use of private health care services, diagnosed asthma/COPD or excessive polypharmacy was associated with having discrepancies. Discrepancies were more common among clients with better functioning and ability to self-manage drug use. Agreement between in-home interview data and EMRs was very good or good for other drug groups, but moderate for opioids, paracetamol, benzodiazepines and benzodiazepine-related drugs and lubricant eye drops, and poor for selective beta-2-adrenoceptor agonists. The most common clinically important discrepancies were psychotropics, opioids and agents acting on the renin-angiotensin system and beta-blocking agents.
  
  
  CONCLUSIONS
  Eight out of ten home care clients had discrepancies between in-home interview data and EMRs. Of these discrepancies, 40% were clinically important.
authors.affiliation: University of Eastern Finland, Kuopio, Finland.
authors.forename: Miia
authors.initials: M
authors.lastname: Tiihonen
authors.affiliation: University of Eastern Finland, Kuopio, Finland.
authors.forename: Irma
authors.initials: I
authors.lastname: Nykänen
authors.affiliation: University of Eastern Finland, Kuopio, Finland.
authors.forename: Riitta
authors.initials: R
authors.lastname: Ahonen
authors.affiliation: University of Eastern Finland, Kuopio, Finland.
authors.forename: Sirpa
authors.initials: S
authors.lastname: Hartikainen
mesh_terms: D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D057286:Electronic Health Records / Q000592:standards / Q000706:statistics & numerical data*; D005387:Finland; D006699:Home Care Services / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D055553:Prescription Drugs / Q000008:administration & dosage / Q000627:therapeutic use*; D012646:Self Administration / Q000706:statistics & numerical data; D057566:Self Report
chemical_list: D055553:Prescription Drugs
keywords: discrepancies; drugs; electronic medical record; home care; older people; pharmacoepidemiology