A recent study of almost 400,000 Ontario hospital patients showed that there was a significant risk that patients would unintentionally discontinue taking vital prescription medications after discharge.
This study tracked elderly patients who were on at least 1 of 5 medications for chronic disease (statins, thyroid medications, anti-coagulants, inhalers for respiratory diseases and gastric acid suppressing drugs) when being admitted to the hospital. More than 19% of these patients did not renew these prescriptions in the three months following their discharge from the hospital. For those who had been admitted to the ICU, this number increased to 23%. Not surprisingly, within one year, there was a significant risk of hospitalization or death for those patients who had discontinued their medications.
The authors of the study theorize that “transitions in care are vulnerable periods for patients during hospitalization. Medical errors during this period can occur as a result of incomplete or inaccurate communication as responsibility shifts from one physician to another.”
Another contributing factor may also be that, during the hospital stay, the patient is relieved of the responsibility of taking the right medications at the right time as this is handled by the nursing staff. In other words, they forget and/or get out of the routine. When they return home after a hospital stay, there may be new medications that have been added which they may believe have replaced their previous prescriptions. In any event, the hospital stay, particularly if it involved the ICU, is a watershed event that can create confusion or at least the sense of the beginning of a new routine.
Better hospital discharge procedures and the introduction of technology that would track medical records more effectively could go a long way towards fixing this problem. But, this is a wake-up call for those responsible for the homecare of seniors discharged from the hospital – family doctors, family members and home caregivers. It is essential to understand and track all prescriptions and ensure the medications that a post-operative patient is taking are the correct ones.
Even more importantly, this study speaks to the importance of families and caregivers keeping accurate, up-to-date and easily accessible medication records for their loved ones. These records should accompany the patient at the time of hospital admission (emergency or planned). Hospital personnel may not always rebuild a complete medication profile if these records aren’t available. Therefore, it’s not surprising that many medications are unintentionally discontinued after a hospital stay.