Journal article
Getting to Complete and Accurate Medication Lists During the Transition to Home Health Care
Journal of the American Medical Directors Association, v 22(5), pp 1003-1008
May 2021
PMID: 32723536
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Characterize the work that home health care (HHC) admission nurses complete as part of the medication reconciliation tasks, explore the impact of shared electronic medication data (interoperability) from the referral source on medication reconciliation, and highlight opportunities to enhance medication reconciliation with respect to transition in care to HHC agencies.
Observational field study.
Three diverse Pennsylvania HHC agencies; each used different electronic health record systems with different interoperability characteristics. Six nurses per site admitted 2 patients each (36 patients total).
Researchers observed the admission process in the patient home and at the HHC agency. The nurses’ tasks related to medication reconciliation were characterized by (1) number and change types (ie, medications dropped or added; changes to dose, frequency/administration time, or tablet types) made to the referrer medication list during and after the home visit, and (2) reasons that the nurse called the health provider (doctor, pharmacy) to resolve medication-related issues. Differences between interoperable and non-interoperable observations were explored.
Polypharmacy (on average, study patients were taking more than 12 medications) and high-risk medications (on average, more than 8 per patient) were pervasive. For 91% of patients, the number of medications decreased between pre- and post-reconciliation medication lists; 41% of the medications required changes. Nurses using interoperable systems needed to make fewer changes than nurses using non-interoperable systems. In two-thirds of observations, the nurse called a provider.
Changes to the referrer medication list and calls to providers highlighted the nurses’ effort to complete the medication reconciliation. Interoperability appeared to reduce the number of changes required, but did not eliminate changes or calls to providers. We highlight opportunities to enhance medication reconciliation with respect to transition in care to HHC agencies.
Metrics
Details
- Title
- Getting to Complete and Accurate Medication Lists During the Transition to Home Health Care
- Creators
- Claire Champion - Department of Health Promotion and Development, University of Pittsburgh School of Nursing, Pittsburgh, PAPaulina S. Sockolow - Drexel University College of Nursing and Health ProfessionsKathryn H. Bowles - Visiting Nurse Service of New YorkSheryl Potashnik - Drexel University College of Nursing and Health ProfessionsYushi Yang - Drexel UniversityCarl Pankok - Drexel UniversityNatasha Le - University of PennsylvaniaElease McLaurin - Drexel University College of Nursing and Health ProfessionsEllen J. Bass - Drexel University
- Publication Details
- Journal of the American Medical Directors Association, v 22(5), pp 1003-1008
- Publisher
- Elsevier
- Grant note
- R01 HS024537 / Agency for Healthcare Research and Quality (https://doi.org/10.13039/100000133)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Information Science; Civil, Architectural, and Environmental Engineering; Health Sciences Division
- Web of Science ID
- WOS:000651403200016
- Scopus ID
- 2-s2.0-85088801070
- Other Identifier
- 991019168123304721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Geriatrics & Gerontology