Improving the Management of Patients' Own Medications in Hospitalized Older Adults: A Multidisciplinary...

Patients' own medications (POMs) may pose safety risks when their use is not integrated into hospital medication-management processes. This study evaluated a multidisciplinary intervention for POM management in hospitalized older adults.

This single-center before-and-after intervention study was conducted from March 2024 to February 2025. The intervention comprised five coordinated components: physician-led assessment, authorization, order entry, guidance, and monitoring; pharmacist-led verification, order review, and record maintenance; nurse-led verification, supervision, and education using color-coded labels (green, approved for use; red, not to be used; yellow, awaiting confirmation); IT-led integration of POM information into the electronic medication administration record; and procurement-led upgrades to storage equipment. The primary outcome was the incidence rate of POM-related medication errors per 1000 patient-days. Secondary outcomes were correct POM documentation within 24 hours of admission and correct POM storage at the pre-discharge assessment.

The study included 162 patients, with 81 in each period. Before the intervention, 174 POM-related medication errors occurred over 1628 patient-days (106.9 per 1000 patient-days), compared with 29 errors over 1581 patient-days after the intervention (18.3 per 1000 patient-days). The incidence rate ratio was 0.172 (95% CI, 0.116-0.254; P<0.001), representing an 82.8% reduction. Correct POM documentation within 24 hours increased from 53.1% (43/81) to 92.6% (75/81; χ ²=31.951, P<0.001; OR=11.047, 95% CI, 4.319-28.253; RR=1.744, 95% CI, 1.408-2.160). Correct POM storage at the pre-discharge assessment increased from 32.1% (26/81) to 84.0% (68/81; χ ²=44.707, P<0.001).

The intervention was associated with improvements in all three measured POM outcomes at this center. Multicenter studies with longer follow-up are needed to assess generalizability and sustainability.