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Primary care physician communication at hospital discharge reduces medication discrepancies

Authors

  • Lee A. Lindquist MD, MPH, MBA,

    Corresponding author
    1. Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
    • Address for correspondence and reprint requests: Lee Lindquist, MD, Associate Professor of Medicine, Northwestern University Feinberg School of Medicine, 750 North Lake Shore Drive, 10th Floor, Chicago, IL 60611; Telephone: 312–695-4525; Fax: 312–695-6060; E-mail: lal425@md.northwestern.edu

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  • Atsuko Yamahiro MD,

    1. Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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  • Arianne Garrett BS,

    1. Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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  • Charles Zei BS,

    1. Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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  • Joseph M. Feinglass PhD, MPH

    1. Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Abstract

BACKGROUND

Medication discrepancies are common as patients transition from hospital to home. Errors with post-discharge medication regimens may play a role in hospital readmissions.

OBJECTIVES

To determine whether primary care physician (PCP) contact with patients at hospital discharge impacts the frequency of medication discrepancies at 24 hours post-discharge.

DESIGN

With the PCP-Enhanced Discharge Communication Intervention, PCPs were asked to speak with treating hospitalists and contact patients within 24 hours of hospital discharge (either in person or by phone) to discuss any hospital medication changes. Research staff enrolled subjects during their hospitalization and telephoned subjects 48 hours post-discharge to determine medication discrepancies and PCP contact.

PARTICIPANTS

One hundred fourteen community-dwelling adults, admitted to acute medicine services >24 hours on ≥5 medications.

RESULTS

Of the 114 subjects enrolled in the hospital, 75 subjects completed 48 hours postdischarge phone interviews. Of the 75 study patients, 39 patients (50.6%) experienced a total of 84 medication discrepancies (mean, 2.1 discrepancies/patient). Subjects who were contacted by their PCP at discharge were 70% less likely to have a discrepancy when compared with those not contacted (P = 0.04). Males were 4.34 times more likely to have a discrepancy (P = 0.02).

CONCLUSION

PCP communication with patients within 24 hours of discharge was associated with decreased medication discrepancies. Our results further demonstrate the importance of PCP involvement in the hospital discharge process. Journal of Hospital Medicine 2013;8:672–677. © 2013 Society of Hospital Medicine

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