Medication discrepancy rates and sources upon nursing home intake: A prospective study

Area of Science:

• Gerontology
• Health Services Research
• Pharmacoeconomics

Background:

• Medication discrepancies at nursing home intake elevate the risk of adverse drug events.
• Identifying discrepancy rates and origins aids in pinpointing information exchange deficits for high-risk medications.

Purpose of the Study:

• Determine class-specific medication discrepancy rates.
• Identify discordance between medication lists.
• Explore patient and system factors linked to discrepancies during nursing home intake.

Main Methods:

• Prospective data collection from four long-term care facilities over nine months.
• Defined discrepancies as mismatched prescribing orders between at least two medication history lists.
• Used logistic regression to identify high-discrepancy medication classes and associated patient factors.

Main Results:

• 40.8% of residents and 6.3% of medications had discrepancies during the second reconciliation.
• Respiratory and analgesic medications were twice as likely to be discrepant.
• Most discrepancies involved hospital and nursing home lists (44.9%) or hospital, nursing home, and pharmacy lists (39.3%).

Conclusions:

• Transitions of care teams should prioritize residents with respiratory conditions or pain due to higher discrepancy risks.
• Poorer health status in re-admitted residents contributes to discrepancy risk.
• Further research is needed to clarify system failures in communication across care settings.