Measuring the Severity of Medication Discrepancies: A Community Pharmacy Perspective

2 Overview Background Introduction Medication Discrepancies Potential-to-harm scale Data Limitations Conclusion

3 Background The Journal of the American Medical Association recently said that if adverse reactions to medications were classified as a distinct disease, it would rank as the 5th leading cause of death in the USA.

4 Introduction Modern Medicine = More Diagnoses = More Treatment Options = More Drugs Dispensed However, Increased Potential for Medication Discrepancies Increased Risk of Medication Errors

5 Introduction What does this mean to pharmacists? = The integrated management of medication regimes to decrease the number of medication discrepancies

6 Introduction Our study sought to investigate the prevalence of medication discrepancies in two population cohorts leaving hospital care for either a: Outpatient Renal Ward Long Term Care Facility

7 Medication Discrepancy Medication discrepancies, for our purposes, were taken to be any discontinuity between the pharmacy database and any other listing of the patients' medications, e.g. hospital records.

8 Methods Each patient was interviewed about his/her medication regimen. Discrepancies were rated for potential short and long term risks based upon a novel potential-to-harm (PTH) scale The PTH scale was devised to gauge the severity of each discrepancy

9 Potential-to-Harm Scale Categorical assessments were carried out by pharmacists Potential risks in both short and long term were considered

10 Examples Example: Short Term Risk, Low Risk of Discomfort or Harm (S1): Patient's community pharmacy list did not include docusate sodium for prevention of constipation secondary to chronic narcotic use but patient is using regularly.

11 Examples Example: Long Term Risk, High Risk of Discomfort or Harm (L3): Patient's community pharmacy list included Warfarin 1mg OD but the current dose was for 2.5mg OD.

12 Med Rev Form

13 Results – Analysis

14 Results – No. of Meds

15 Results – Analysis

16 Results – Analysis

17 Limitations The sample size for this study was small, 48 patients, and therefore may not be a true representation of the population. There is a degree of interviewer subjectivity in performing the medication reconciliations which may influence the results.

18 Conclusion Extrapolating from the data, we can make the following conclusions and observation: Both populations displayed severe risks resulting from medication discrepancies.

19 Conclusion Both populations displayed severe risks resulting from medication discrepancies. Renal patients had more discrepancies than long term care patients. Possibly the more the patient controls their own medication the more problems that can arise.

20 Conclusion Regular medication reconciliations decrease the number of medication discrepancies. Medication reconciliations are an important tool available to community pharmacists and can be used to improve the delivery of seamless patient care.

21 Conclusion By doing medication reconciliation we have shown that it can improve patient outcomes. The data and results of this study provide a stepping stone to further study in regards to medication related problems.

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