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Medication Prescribing Observations in Care Transitions for Incarcerated Patients.

Bethany R Shoulders1, Kelly L Maguigan2,3, Stephen J Lemon2

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|January 22, 2026
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Medication reconciliation for incarcerated patients is challenging, leading to frequent discrepancies in medication lists during care transitions. Standardized processes are needed to improve care continuity for this population.

Keywords:
chronic diseaseincarcerated patientsmedication discrepanciestransitions in care

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Area of Science:

  • Medical Informatics
  • Health Services Research
  • Pharmacology

Background:

  • Incarcerated individuals face unique challenges in medication management due to limited access to electronic health records and verification methods.
  • Traditional medication reconciliation strategies may be inadequate, potentially causing delays and errors during hospital care transitions.
  • This study addresses the need for improved medication management in correctional healthcare settings.

Purpose of the Study:

  • To investigate the prevalence and nature of discrepancies in medication lists and chronic disease diagnoses for incarcerated patients during hospital admission and discharge.
  • To identify specific challenges in medication management for this vulnerable population.
  • To provide evidence for improving care continuity and patient safety.

Main Methods:

  • A retrospective analysis of medication lists and chronic disease states (using Charlson Comorbidity Index) for incarcerated adults admitted and discharged between January 1, 2017, and December 31, 2020.
  • Assessment of medication and diagnostic data at two critical care transitions: hospital admission and discharge.
  • Focus on pre-specified comorbidities to identify missing or duplicate medications.

Main Results:

  • Of 417 patients with active prescriptions on admission, an average of 8 medications per patient were recorded.
  • Diagnostic discrepancies were infrequent (3.9%), with new conditions often identified at discharge.
  • Fifty-five percent of patients with pre-specified comorbidities experienced at least one medication discrepancy, averaging 1.65 comorbidities reviewed per patient.

Conclusions:

  • Incarcerated patients experience a high rate of medication discrepancies during hospital transitions, despite low rates of diagnostic differences.
  • Healthcare systems must develop standardized, streamlined medication reconciliation processes tailored to the unique needs of incarcerated individuals.
  • Improved institutional policies are crucial to enhance care continuity and mitigate risks for this population.