Abstract
Purpose
We have developed a model for integrated medicines management, including tools and activities for medication reconciliation and medication review. In this study, we focus on improving the quality of the discharge summary including the medication report to reduce medication errors in the transition from hospital to primary and community care.
Methods
This study is a longitudinal study with an intervention group and a control group. The intervention group comprised 52 patients, who were included from 1 March 2006 until 31 December 2006, with a break during summer. Inclusion in the control group was performed in the same wards during the period 1 September 2005 until 20 December 2005, and 63 patients were included in the control group. In order to improve the quality of the medication report, clinical pharmacists reviewed and gave feedback to the physician on the discharge summary before patient discharge, using a structured checklist. Medication errors were then identified by comparing the medication list in the discharge summary with the first medication list used in the community health care after the patient had returned home.
Results
By improving the quality of the discharge summary, patients had on average 45% fewer medication errors per patient (P = 0.012). The proportion of patients without medication errors was 63.5% in the control group and 73.1% in the intervention group. However, this increase was not significant (P = 0.319). Patients who used a specific medication dispensing system (ApoDos) had a 5.9-fold higher risk of suffering from medication errors than those without this medication dispensing system (P < 0.001).
Conclusion
Review and feedback on errors in the discharge summary, including the medication report and a correct medication list, reduced medication errors during the transfer of information from hospital to primary and community care.
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Acknowledgements
First, we would like to thank the students Helena Lindholm and Cecilia Bergkvist for collecting the majority of the data. We would also like to thank the staff at the Department of Internal Medicine at Landskrona Hospital, especially Dr Per Löfdahl, the nurses in the community health care, and the clinical pharmacists Sofia Jönsson and Emma Olsson for excellent cooperation and work.
Funding
We are grateful to the National Board of Health and Welfare, the Swedish Academy of Pharmaceutical Sciences, the County of Skåne and Apoteket AB for funding the study.
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Bergkvist, A., Midlöv, P., Höglund, P. et al. Improved quality in the hospital discharge summary reduces medication errors—LIMM: Landskrona Integrated Medicines Management. Eur J Clin Pharmacol 65, 1037–1046 (2009). https://doi.org/10.1007/s00228-009-0680-1
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DOI: https://doi.org/10.1007/s00228-009-0680-1