Medication errors such as omissions, duplications, incorrect dosing, or harmful drug interactions are common, and seniors are exceptionally vulnerable to medication errors. One reason is that they tend to take more medication than other age groups. Another is that, due to a decline in mental status caused by age and sickness, they may have lower comprehension. What is most daunting is that approximately 30 percent of medication errors have great potential to cause harm to the patient.
Medication errors most often occur when patients move between healthcare settings. They can happen in the hospital setting, but discrepancies also often occur at discharge and may cause problems in community health care practice. Some of the common errors upon discharge include unintentional omissions or continuation of drugs which had been ceased. Patients with one or more drug errors on their discharge summary are also at a higher risk of being re-admitted to the hospital.
The process of medication reconciliation can significantly decrease errors. Medication reconciliation is the practice of comparing an individual’s prescribed medication list to the actual medications that the person has been taking, to identify and resolve any discrepancies.
In home care, we often see clients who were discharged with a medication summary that is correct (no errors) however, the client is non-compliant in some way that causes themselves dangerous risks. For example, they may not fill their new prescriptions for new medications that were started in the hospital and recommended to be continued. They may not do this for a number of reasons: they didn’t comprehend the instructions to do so, they didn’t have any way to get them filled, or they were afraid of the costs. Regardless of the reason, this is a very dangerous situation and the patient could easily wind up back in the hospital or worse.
Sometimes patients do not trust the discharge orders and say that they are waiting to ask their primary doctor at their follow up appointment. While the trusting relationship that they have with their primary physician is great, waiting 4-6 weeks until a follow up appointment to take prescribed medications can be very unsafe.
At times, patients who do fill their discharge prescriptions are prescribed generic drugs instead of the brand names they are used to. If they don’t recognize the name, they may begin taking both the generic and the brand name that they had at home. Taking double the prescribed dosage of certain medications can cause serious problems. Too much blood pressure medicine could make you light-headed and too much diabetes medicine can cause low blood sugar. You are also likely to run out of the medication sooner than you should.
When you or your loved one are transferring from a healthcare setting back into the home setting, consider using a house call physician, or a home health company that sends clinicians into the home to do a full medication reconciliation. These medical professionals will collaborate with patients and their family, caregivers, and other healthcare providers to ensure safety and compliance. Allegiance Aging Care Services offers a full medication reconciliation as a part of its Extended Care Program.
About the Author: Pam Reynolds, CMC is the President and co-owner of Allegiance Aging Care Services. Pam has spent almost fifteen years working in senior care including long term care facilities and home health care. Her higher education is in Social Work, and she has been credentialed as both a certified Geriatric Care Manager and Licensed Assisted Living Administrator. Read more about Pam and her team of Aging Care Professionals here.