Omitted and unjustified medications in the discharge summary
Background:Limited information exists in regard to drug omissions and unjustified medications in the hospital discharge summary (DS).Objective:To evaluate the incidence and types of drug omissions and unjustified medications in the DS, and to assess their potential impact on patient health.Methods:A...
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| Veröffentlicht in: | Quality & safety in health care 2009-06, Vol.18 (3), p.205-208 |
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| creator | Perren, A Previsdomini, M Cerutti, B Soldini, D Donghi, D Marone, C |
| description | Background:Limited information exists in regard to drug omissions and unjustified medications in the hospital discharge summary (DS).Objective:To evaluate the incidence and types of drug omissions and unjustified medications in the DS, and to assess their potential impact on patient health.Methods:A prospective observational review of the DSs of all patients discharged from our Internal Medicine Department over a 3-month period. Data assessment was made by internists using a structured form.Results:Of the 577 evaluated DSs, 66% contained at least one inconsistency accounting for a total of 1012 irregularities. There were 393 drug omissions affecting 251 patients, 32% of which were potentially harmful. Seventeen per cent of all medications (619/3691) were unjustified, affecting 318 patients. The unjustified medication was potentially harmful in 16% of cases, occurred significantly more frequent in women than in men (61% vs 50%; p = 0.008) and increased linearly with the number of drugs prescribed (p |
| doi_str_mv | 10.1136/qshc.2007.024588 |
| format | Article |
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Data assessment was made by internists using a structured form.Results:Of the 577 evaluated DSs, 66% contained at least one inconsistency accounting for a total of 1012 irregularities. There were 393 drug omissions affecting 251 patients, 32% of which were potentially harmful. Seventeen per cent of all medications (619/3691) were unjustified, affecting 318 patients. The unjustified medication was potentially harmful in 16% of cases, occurred significantly more frequent in women than in men (61% vs 50%; p = 0.008) and increased linearly with the number of drugs prescribed (p<0.001). Drug omission had a twofold higher potential to cause harm than unjustified medication.Conclusions:Drug omissions and unjustified medications are frequent, and systemic changes are required to substantially reduce these inconsistencies.</description><identifier>ISSN: 1475-3898</identifier><identifier>EISSN: 1475-3901</identifier><identifier>DOI: 10.1136/qshc.2007.024588</identifier><identifier>PMID: 19468003</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd</publisher><subject>Accuracy ; Aged ; Classification ; Data collection ; Documentation ; Family physicians ; Female ; Health administration ; Hospitals ; Humans ; Internal medicine ; Male ; Medical errors ; Medical records ; Medical Records - standards ; Medication Errors ; Middle Aged ; Mortality ; Patient Discharge - statistics & numerical data ; Physicians ; Prescription Drugs ; Prospective Studies ; Quality control ; Studies ; Switzerland</subject><ispartof>Quality & safety in health care, 2009-06, Vol.18 (3), p.205-208</ispartof><rights>2009 BMJ Publishing Group Ltd</rights><rights>Copyright: 2009 2009 BMJ Publishing Group Ltd</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b441t-9b3adb3600eaa308fdf30f82fc4e4f5440eab281eefc0ec1be764b078b87c8cd3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://qualitysafety.bmj.com/content/18/3/205.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://qualitysafety.bmj.com/content/18/3/205.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,3183,23550,27901,27902,77569,77600</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19468003$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Perren, A</creatorcontrib><creatorcontrib>Previsdomini, M</creatorcontrib><creatorcontrib>Cerutti, B</creatorcontrib><creatorcontrib>Soldini, D</creatorcontrib><creatorcontrib>Donghi, D</creatorcontrib><creatorcontrib>Marone, C</creatorcontrib><title>Omitted and unjustified medications in the discharge summary</title><title>Quality & safety in health care</title><addtitle>Qual Saf Health Care</addtitle><description>Background:Limited information exists in regard to drug omissions and unjustified medications in the hospital discharge summary (DS).Objective:To evaluate the incidence and types of drug omissions and unjustified medications in the DS, and to assess their potential impact on patient health.Methods:A prospective observational review of the DSs of all patients discharged from our Internal Medicine Department over a 3-month period. Data assessment was made by internists using a structured form.Results:Of the 577 evaluated DSs, 66% contained at least one inconsistency accounting for a total of 1012 irregularities. There were 393 drug omissions affecting 251 patients, 32% of which were potentially harmful. Seventeen per cent of all medications (619/3691) were unjustified, affecting 318 patients. The unjustified medication was potentially harmful in 16% of cases, occurred significantly more frequent in women than in men (61% vs 50%; p = 0.008) and increased linearly with the number of drugs prescribed (p<0.001). Drug omission had a twofold higher potential to cause harm than unjustified medication.Conclusions:Drug omissions and unjustified medications are frequent, and systemic changes are required to substantially reduce these inconsistencies.</description><subject>Accuracy</subject><subject>Aged</subject><subject>Classification</subject><subject>Data collection</subject><subject>Documentation</subject><subject>Family physicians</subject><subject>Female</subject><subject>Health administration</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Internal medicine</subject><subject>Male</subject><subject>Medical errors</subject><subject>Medical records</subject><subject>Medical Records - standards</subject><subject>Medication Errors</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Patient Discharge - statistics & numerical data</subject><subject>Physicians</subject><subject>Prescription Drugs</subject><subject>Prospective Studies</subject><subject>Quality control</subject><subject>Studies</subject><subject>Switzerland</subject><issn>1475-3898</issn><issn>1475-3901</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkEtLxDAURoMovveupCC4kY43jzYpuJHBtyiIirgJSZo4GaetNi3ovzdDRwU3rvI697s3B6EdDCOMaX74HiZmRAD4CAjLhFhC65jxLKUF4OXvvSjEGtoIYQqAC1LgVbSGC5YLALqOjm4r33W2TFRdJn097UPnnY_nypbeqM43dUh8nXQTm5Q-mIlqX2wS-qpS7ecWWnFqFuz2Yt1ED6cn9-Pz9Pr27GJ8fJ1qxnCXFpqqUtMcwCpFQbjSUXCCOMMscxlj8V4Tga11BqzB2vKcaeBCC26EKekm2h9y39rmvbehk1Ucxc5mqrZNH2TOCeeUkgju_QGnTd_WcTaJOReC5DE1UjBQpm1CaK2Tb62f_0dikHOvcu5Vzr3KwWss2V0E9zqa-S1YiIxAOgA-dPbj5121r3E6yjN58ziW2TN5Or-8OpN3kT8YeF1N_2__BdHqkPk</recordid><startdate>200906</startdate><enddate>200906</enddate><creator>Perren, A</creator><creator>Previsdomini, M</creator><creator>Cerutti, B</creator><creator>Soldini, D</creator><creator>Donghi, D</creator><creator>Marone, C</creator><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>200906</creationdate><title>Omitted and unjustified medications in the discharge summary</title><author>Perren, A ; Previsdomini, M ; Cerutti, B ; Soldini, D ; Donghi, D ; Marone, C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b441t-9b3adb3600eaa308fdf30f82fc4e4f5440eab281eefc0ec1be764b078b87c8cd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Accuracy</topic><topic>Aged</topic><topic>Classification</topic><topic>Data collection</topic><topic>Documentation</topic><topic>Family physicians</topic><topic>Female</topic><topic>Health administration</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Internal medicine</topic><topic>Male</topic><topic>Medical errors</topic><topic>Medical records</topic><topic>Medical Records - standards</topic><topic>Medication Errors</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Patient Discharge - statistics & numerical data</topic><topic>Physicians</topic><topic>Prescription Drugs</topic><topic>Prospective Studies</topic><topic>Quality control</topic><topic>Studies</topic><topic>Switzerland</topic><toplevel>online_resources</toplevel><creatorcontrib>Perren, A</creatorcontrib><creatorcontrib>Previsdomini, M</creatorcontrib><creatorcontrib>Cerutti, B</creatorcontrib><creatorcontrib>Soldini, D</creatorcontrib><creatorcontrib>Donghi, D</creatorcontrib><creatorcontrib>Marone, C</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Quality & safety in health care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Perren, A</au><au>Previsdomini, M</au><au>Cerutti, B</au><au>Soldini, D</au><au>Donghi, D</au><au>Marone, C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Omitted and unjustified medications in the discharge summary</atitle><jtitle>Quality & safety in health care</jtitle><addtitle>Qual Saf Health Care</addtitle><date>2009-06</date><risdate>2009</risdate><volume>18</volume><issue>3</issue><spage>205</spage><epage>208</epage><pages>205-208</pages><issn>1475-3898</issn><eissn>1475-3901</eissn><abstract>Background:Limited information exists in regard to drug omissions and unjustified medications in the hospital discharge summary (DS).Objective:To evaluate the incidence and types of drug omissions and unjustified medications in the DS, and to assess their potential impact on patient health.Methods:A prospective observational review of the DSs of all patients discharged from our Internal Medicine Department over a 3-month period. Data assessment was made by internists using a structured form.Results:Of the 577 evaluated DSs, 66% contained at least one inconsistency accounting for a total of 1012 irregularities. There were 393 drug omissions affecting 251 patients, 32% of which were potentially harmful. Seventeen per cent of all medications (619/3691) were unjustified, affecting 318 patients. The unjustified medication was potentially harmful in 16% of cases, occurred significantly more frequent in women than in men (61% vs 50%; p = 0.008) and increased linearly with the number of drugs prescribed (p<0.001). Drug omission had a twofold higher potential to cause harm than unjustified medication.Conclusions:Drug omissions and unjustified medications are frequent, and systemic changes are required to substantially reduce these inconsistencies.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd</pub><pmid>19468003</pmid><doi>10.1136/qshc.2007.024588</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Accuracy Aged Classification Data collection Documentation Family physicians Female Health administration Hospitals Humans Internal medicine Male Medical errors Medical records Medical Records - standards Medication Errors Middle Aged Mortality Patient Discharge - statistics & numerical data Physicians Prescription Drugs Prospective Studies Quality control Studies Switzerland |
| title | Omitted and unjustified medications in the discharge summary |
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