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Limited effect of structured medication report as the only intervention at discharge from hospital
  1. Hanne Holdhus1,
  2. Katrine Bøvre1,
  3. Liv Mathiesen1,2,
  4. Börje Bjelke3,
  5. Kathrin Bjerknes1
  1. 1 Hospital Pharmacy Enterprices, South Eastern Norway, Oslo, Norway
  2. 2 Department of Pharmaceutical Biosciences, School of Pharmacy, University of Oslo, Oslo, Norway
  3. 3 Department of Neurology, Akershus University Hospital, Lørenskog, Norway
  1. Correspondence to Dr Kathrin Bjerknes, Hospital Pharmacies Enterprise, South Eastern Norway, Oslo 1478, Norway; kathrin.bjerknes{at}sykehusapotekene.no

Abstract

Objective To investigate whether a structured medication report at discharge from the hospital could reduce the number of medication discrepancies in primary care.

Method The study was performed as an open, randomised controlled study including patients transferred from one hospital in Norway to nursing home or home care. Both groups received epicrisis on discharge. In addition, the intervention group received a structured medication report. After discharge, the medication list in primary care service was compared with the list at discharge and medication discrepancies identified. In addition, these medication lists were retrospectively compared with the lists prior to admission to the hospital and at admission to hospital. A questionnaire on time spent and quality of the medication information was filled in by nurses in primary care.

Results Medication discrepancies were found for 72% (26) of the patients in the intervention group and 76% (42) in the control group (P=0.918). Most common was drugs omitted or committed to the medication lists in primary care service. Typically, the committed drugs in primary care were omitted drugs after admission to the hospital. Nurses used significantly less time (66%) obtaining medication information in the intervention group (P=0.041).

Conclusions Structured medication report as the only intervention did not reduce the medication discrepancies after discharge from hospital. There is a need for reconciliation at admission to ensure the quality of the medication report. Structured medication report resulted in the nurses spending less time on collecting medication information in primary care service.

  • medication reconciliation
  • medication discrepancies
  • discharge from hospital
  • primary care
  • medication list

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