TITLE:
Medication Error and Interprofessional Communication-Related Factors Contributing to Hospitalisation in Community-Dwelling Older Adults in Australia
AUTHORS:
Julie Hanson, Arif Manji, Steven Coverdale, Bernadette Morris-Smith, Marianne Wallis
KEYWORDS:
Medication Error, Aged, Hospital Admission, Length of Stay, Discharge Communication
JOURNAL NAME:
Open Journal of Nursing,
Vol.11 No.10,
October
28,
2021
ABSTRACT: Background: Population ageing is a worldwide phenomenon. It is common for older adults to develop multiple age-related illnesses and the prevalence of multimorbidity increases substantially with age. Multimorbid adults are frequently treated with several concurrent medications and the regimen may be complex requiring multiple steps in the preparation of a medication prior to its administration. Polypharmacy is a concerning trend and older adults have a 100% risk of experiencing adverse drug events when taking ten or more medications concurrently. Discharge summaries communicating the number of medications, changes made to medication regimens during hospitalisations and the requirement for ongoing monitoring in the community are often incomplete. The aim of this study was to investigate contributing factors to medication-related hospitalisation, length of stay or readmission in older community-dwelling persons and examine the quality of discharge summaries. Methods: Descriptive and correlational analyses of demographic, clinical, admission, readmission, length of stay and medication variables were examined in Australia in 2016-2018. Discharge summaries were analysed for completeness, timeliness and interprofessional communication. Results: There were 295 participants, mean age 80 years, 55% were female, taking an average of 11 prescribed medications and with a mean Medication Regimen Complexity Index score of 34. Medication errors that were unrecognised at the time of hospitalisation were present in 19% of the sample. Factors associated with medication error were older age and a longer median length of stay. Fewer than 52% of these older patients had detailed discharge summaries. Conclusion: The prevalence of polypharmacy and medication regimen complexity at admission was high. A high proportion of older adults on medical units may have unrecognised medication errors impacting their admission. Medical discharge summaries are inadequately addressing this issue for patients returning to the care of their family physician.