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Elliott RA, Tran T, Taylor SE, et al. Impact of a pharmacist-prepared interim residential care medication administration chart on gaps in continuity of medication management after discharge from hospital to residential care: a prospective pre- and post-intervention study (MedGap Study). BMJ Open. 2012;2(3)doi: 10.1136/bmjopen-2012-000918.
Elliott, R. A., Tran, T., Taylor, S. E., Harvey, P. A., Belfrage, M. K., Jennings, R. J., & Marriott, J. L. (2012). Impact of a pharmacist-prepared interim residential care medication administration chart on gaps in continuity of medication management after discharge from hospital to residential care: a prospective pre- and post-intervention study (MedGap Study). BMJ open, 2(3), . https://doi.org/10.1136/bmjopen-2012-000918
Elliott, Rohan A, et al. "Impact of a pharmacist-prepared interim residential care medication administration chart on gaps in continuity of medication management after discharge from hospital to residential care: a prospective pre- and post-intervention study (MedGap Study)." BMJ open vol. 2,3 (2012). doi: https://doi.org/10.1136/bmjopen-2012-000918
Elliott RA, Tran T, Taylor SE, Harvey PA, Belfrage MK, Jennings RJ, Marriott JL. Impact of a pharmacist-prepared interim residential care medication administration chart on gaps in continuity of medication management after discharge from hospital to residential care: a prospective pre- and post-intervention study (MedGap Study). BMJ Open. 2012 May 25;2(3). doi: 10.1136/bmjopen-2012-000918. Print 2012. PMID: 22637373; PMCID: PMC3367148.
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BMJ Open. 2012 May 25;2(3). doi: 10.1136/bmjopen-2012-000918. Print 2012.

Impact of a pharmacist-prepared interim residential care medication administration chart on gaps in continuity of medication management after discharge from hospital to residential care: a prospective pre- and post-intervention study (MedGap Study).

BMJ open

Rohan A Elliott, Tim Tran, Simone E Taylor, Penelope A Harvey, Mary K Belfrage, Rhonda J Jennings, Jennifer L Marriott

Affiliations

  1. Pharmacy Department, Austin Health, Heidelberg, Australia.

PMID: 22637373 PMCID: PMC3367148 DOI: 10.1136/bmjopen-2012-000918

Abstract

OBJECTIVES: To test the impact of a hospital pharmacist-prepared interim residential care medication administration chart (IRCMAC) on medication administration errors and use of locum medical services after discharge from hospital to residential care.

DESIGN: Prospective pre-intervention and post-intervention study.

SETTING: One major acute care hospital and one subacute aged-care hospital; 128 residential care facilities (RCF) in Victoria, Australia.

PARTICIPANTS: 428 patients (median age 84 years, IQR 79-88) discharged to a RCF from an inpatient ward over two 12-week periods.

INTERVENTION: Seven-day IRCMAC auto-populated with patient and medication data from the hospitals' pharmacy dispensing software, completed and signed by a hospital pharmacist and sent with the patient to the RCF.

PRIMARY AND SECONDARY OUTCOME MEASURES: Primary end points were the proportion of patients with one or more missed or significantly delayed (>50% of prescribed dose interval) medication doses, and the proportion of patients whose RCF medication chart was written by a locum doctor, in the 24 h after discharge. Secondary end points included RCF staff and general practitioners' opinions about the IRCMAC.

RESULTS: The number of patients who experienced one or more missed or delayed doses fell from 37/202 (18.3%) to 6/226 (2.7%) (difference in percentages 15.6%, 95% CI 9.5% to 21.9%, p<0.001). The number of patients whose RCF medication chart was written by a locum doctor fell from 66/202 (32.7%) to 25/226 (11.1%) (difference in percentages 21.6%, 95% CI 13.5% to 29.7%, p<0.001). For 189/226 (83.6%) discharges, RCF staff reported that the IRCMAC improved continuity of care; 31/35 (88.6%) general practitioners said that the IRCMAC reduced the urgency for them to attend the RCF and 35/35 (100%) said that IRCMACs should be provided for all patients discharged to a RCF.

CONCLUSIONS: A hospital pharmacist-prepared IRCMAC significantly reduced medication errors and use of locum medical services after discharge from hospital to residential care.

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