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An intervention on discharge polypharmacy

D M Smith1, M R Cox, E J Brizendine

  • 1Division of General Medicine, Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, IN 46204, USA.

Journal of the American Geriatrics Society
|April 1, 1996
PubMed
Summary
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Canceling pre-admission prescriptions did not reduce active drug prescriptions at discharge in acute medical settings. Further research is needed to evaluate medication changes during hospitalization.

Area of Science:

  • Clinical Pharmacy
  • Health Services Research
  • Pharmacoeconomics

Background:

  • Hospital discharge medication reconciliation is crucial for patient safety.
  • Managing outpatient prescriptions during inpatient stays presents challenges.
  • Optimizing medication regimens aims to reduce polypharmacy and adverse events.

Purpose of the Study:

  • To assess if a system for canceling pre-admission prescriptions impacts the number of active drug prescriptions at hospital discharge.
  • To evaluate the effectiveness of a specific intervention in streamlining medication management for inpatients.

Main Methods:

  • A randomized, non-blinded clinical trial was conducted on an inpatient acute medical service.
  • Twelve medicine ward teams were assigned to either control or intervention groups.

Related Experiment Videos

  • The intervention group utilized a computer-generated drug list to manage outpatient prescriptions, while the control group did not.

    • Main Results:

    • No significant differences were observed in patient demographics (age, sex, race, Charlson Index) or length of stay (LOS) between groups.
    • The intervention group had fewer prescriptions on admission (5.4 vs 6.2, P < .05).
    • However, the number of prescriptions at discharge was not significantly different between the intervention and control groups (2.9 vs 2.9, P = .87).

    Conclusions:

    • Implementing a method to cancel pre-admission prescriptions did not reduce the number of active drug prescriptions at discharge.
    • The study highlights the need for further investigation into the significant increase in prescriptions from admission to discharge in acute care.
    • Future research should focus on the appropriateness and clinical impact of medication escalation during hospitalization.