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https://hdl.handle.net/2440/8633
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Type: | Journal article |
Title: | Uncovering a multitude of sins: medication management in the home post acute hospitalisation among the chronically ill |
Author: | Stewart, Simon A. Pearson, Sue |
Citation: | Australian and New Zealand Journal of Medicine, 1999; 29(2):220-227 |
Issue Date: | 1999 |
ISSN: | 0004-8291 |
Abstract: | Background: Sub-optimal use of prescribed medication is often associated with unplanned hospitalisation among the chronically ill. Aims: To examine the extent of sub-optimal use of prescribed medication in a ‘high risk’ patient cohort recently discharged from acute hospital care. Methods: Chronically ill patients discharged from acute hospital care (n=342) were studied. At one week post discharge a home visit was performed by a nurse and a pharmacist during which medication management (including compliance and medication—related knowledge) was assessed. Results: During the majority of home visits at least one medication-related problem was detected: approximately half of the cohort subject to a ‘reliable’ pill-count were found to be mal-compliant and almost all demonstrated inadequate medication-related knowledge. Mal-compliance was correlated with ≥ five prescribed medications (Odds ratio [OR] 2.6: p <0.002). Comparatively, lower medication-related knowledge was correlated with age >75 years (OR 2.2: p <0.001), exacerbation of pre-existing chronic illness (OR 2.7: p=0.044) and six years formal education (OR 1.9: p≥0.004). Neither were modulated by extent of in-hospital counselling. Other previously unknown problems detected during the home visit included hoarding of previously prescribed medication (35%) and reducing medication intake to minimise costs (21%). Conclusions: Management of prescribed medications among chronically ill patients recently discharged from acute hospital care is often sub-optimal. Assessment of medication management in the home provides an invaluable opportunity to detect and address problems likely to result in poorer health outcomes. |
Keywords: | Prescribed medications; chronically ill patients; acute hospital care |
Rights: | Copyright © 1999–2012 John Wiley & Sons, Inc. All Rights Reserved. |
DOI: | 10.1111/j.1445-5994.1999.tb00687.x |
Appears in Collections: | Medicine publications |
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