Background and importance Of all readmissions, 21% are medication-related readmissions (MRRs). However, it is unknown whether MRRs are recognised and communicated in the care continuum.
Aim and objectives To assess the proportion of preventable and non-preventable readmissions that contain documentation on the contribution of medication in the patient records (which are then regarded as recognised MRRs).
Material and methods In a previous study, a multidisciplinary team of physicians and pharmacists assessed the medication-relatedness and preventability of unplanned readmissions from seven departments (the gold standard). In the current cross-sectional observational study, patient records were evaluated. A MRR was regarded as documented – and therefore recognised by healthcare providers – when the causal medication(s) was mentioned in patient records (in duplo, using notes from physicians, nurses, pharmacy teams and discharge letters). A MRR was regarded as communicated when documentation was found for the next healthcare providers, patients and/or caregivers. The primary outcome was the proportion of readmissions that contained documentation on the causal medication(s). Secondary outcomes were the differences between the documentation of preventable and non-preventable MRRs and differences in the length of stay (LOS) between documented and undocumented MRRs. Lastly, the proportion of communicated MRRs was assessed. Descriptive data-analysis was used.
Results Of 181 included MRRs, 72 (40%) were deemed preventable by the multidisciplinary team. For 159 of 181 MRRs (88%), documentation on the causal medication(s) was present. The causal medication was documented more often for non-preventable readmissions compared to preventable readmissions (95% vs 78%; p=0.002). The LOS was longer for readmissions where the causal medication was undocumented (median 8 days vs 5 days; p=0.062). Of 159 documented MRRs, 137 (86%) were communicated to the general practitioner, 4 (3%) to the community pharmacy and 93 (59%) to patients and/or caregivers.
Conclusion and relevance This study shows that for 88% of MRRs the causal medication was documented in the patient records. The causal medication was lacking more often for preventable MRRs. These results imply that MRRs are not always recognised, which could impact patients’ wellness as an increased LOS was found for unrecognised MRRs. Communication of MRRs to the next healthcare providers and patients needs improvement.
Conflict of interest No conflict of interest
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