Background and importance The discharge of older hospitalised patients is critical in terms of patient safety, and is partly related to transfer of information about medications from hospitals to the next healthcare provider in primary care. There are to our knowledge no previous studies evaluating information transfer and follow-up, at patient discharge, in a setting where a shared electronic health record (EHR) is used.
Aim and objectives To evaluate the prevalence of patients for whom hospitals sent adequate requests for medication-related follow-up at hospital discharge, the proportion of patients revisiting hospital because of inadequate information and follow-up requests, and the possibility of an association between medication reviews performed during hospitalisation and inadequate follow-up requests.
Material and methods We conducted a retrospective chart review. The study population was randomly selected from a cluster-randomised crossover trial which included patients 65 years or older admitted to four hospitals during 2017–2018. Our study was conducted in regions using a shared electronic health record between hospital and primary care. Each patient was assessed with respect to the adequacy of the request for follow-up. For patients with inadequate requests, data about unplanned hospital revisits were collected, and an assessment made whether the inadequate requests had contributed to the revisits. The association between medication reviews and inadequate requests was analysed with a Chi-square test.
Results A total of 699 patients were included. The patients’ mean age was 80 years; an average of 10 medications were prescribed on hospital admission. The hospitals sent adequate requests for 418 (60%) patients. Thirty-eight patients (14%) had a hospital revisit within 6 months of discharge related to an inadequate request. The proportion of inadequate requests did not differ between patients who had received a medication review during hospitalisation and those who had not (p=0.83).
Conclusion and relevance The prevalence of patients for whom the hospitals sent adequate follow-up requests on discharge was low. More than 10% who had an inadequate follow-up request revisited the hospital within 6 months of discharge for reasons related to the request. Medication reviews conducted during hospitalisation did not affect the proportion of inadequate requests sent. The implementation of a shared EHR did not solve this problematic communication gap.
Conflict of interest No conflict of interest
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.