Characterizing medication discrepancies among older adults during transitions of care: a systematic review focusing on discrepancy synonyms, data sources and classification terms

Author:

Kostas Tia1,Paquin Allison M2,Zimmerman Kristin3,Simone Mark4,Skarf Lara M5,Rudolph James L67

Affiliation:

1. VA Boston Healthcare System, Geriatrics Research, Education & Clinical Center, 150 South Huntington Avenue, Jamaica Plain, MA 02130, USA.

2. VA Boston Healthcare System, Department of Pharmacy (119), 150 South Huntington Avenue, Boston, MA 02130, USA

3. Massachusetts College of Pharmacy & Health Sciences University, 179 Longwood Avenue, Boston, MA 02115, USA

4. Mount Auburn Hospital, 300 Mount Auburn Street, DOB 517, Cambridge, MA 02138, USA

5. VA Boston Healthcare System, Medical Staff Office 111, 1400 VFW Parkway, West Roxbury, MA 02132, USA

6. VA Boston Healthcare System, Geriatrics Research, Education & Clinical Center, 150 South Huntington Avenue, Jamaica Plain, MA 02130, USA

7. Brigham & Women‘s Hospital, Division of Aging, 75 Francis Street, Boston, MA 02115, USA

Abstract

Medication reconciliation is a Joint Commission National Patient Safety Goal prioritized at transitions of care. Medication discrepancies are the reason for, and result of, medication reconciliation. However, their characterization in the literature has not been systematically studied. Older adults are at particularly high risk for medication discrepancies given the prevalence of polypharmacy in this population. The aim was to determine how medication discrepancies among older adults are defined during transitions of care by analyzing synonyms, medication data sources and classification terms. A systematic search of PubMed and EMBASE for primary literature involving medication discrepancies among adults aged ≥50 years during hospital care transitions was carried out. Reviewers consolidated data into like categories and used descriptive statistics to summarize findings. Out of 746 records retrieved, 35 studies were included in this review. In total, 19 studies (54%) were exclusive to adults over 65 years of age. Study settings included hospital discharge (n = 16; 46%), admission (n = 13; 37%) and mixed or multiple transitions (n = 6; 17%). Synonyms for discrepancies included inconsistencies, incongruences, inaccuracies and disagreements, among others. Common data sources included inpatient medication records and medication histories. A comprehensive, best possible medication history utilizing all available medication data sources was recorded in 51% of studies (n = 18), most consistently at admission. Most studies (n = 32; 91%) classified discrepancies; common classification terms included drug dose (n = 28; 88%), omission (n = 26; 80%) and commission (n = 16; 50%). In this first systematic review of medication discrepancy definitions, we found inconsistency across studies. Standardization and common discrepancy nomenclature is necessary for medication reconciliation outcomes to be compared, and to identify best practices to enhance safety. Safety implications are most salient in older adults given the number of medications and transitions of care to which they are exposed, as well as their sensitivity to adverse consequences of medication discrepancies.

Publisher

Future Medicine Ltd

Subject

Geriatrics and Gerontology,General Medicine

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3