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Study Title:
Medication Reconciliation - unintentional discontinuation of long term medication post hospitalisation
Principal Investigator’s (PI) Name: Dr Patrick Redmond
Email: predmond@rcsi.ie
Background:
The use of medications in older patients is arguably one of the most important interventions in modern medicine. People aged over 65 years old are the most active consumers of healthcare. At present 11% of the Irish population are aged 65 years and over. As patients move from home to hospital and back again, their prescribed medications are prone to disruption and the long term medicines used to treat chronic conditions may be stopped either inappropriately or inadvertently and unintentionally. Older patients prescribed multiple medications are most associated with this disruption in medication regimens. This observational study will use the existing and proven data collection tool of the Irish Primary Care Research Network (IPCRN) to describe the potentially unintentional discontinuation of chronic medications following discharge from hospital.
Aims & Objectives:
A retrospective cohort study will be conducted using general practice patient management systems prescribing records and hospital supplied (Healthlink) hospitalisation records from 2011 to 2015 in Ireland. Comparison will be made between prescribing data for those experiencing hospitalisation and those not hospitalised.
Methodology & How to get involved:
An extraction tool for GP PMS (Socrates) has been designed to work with Irish Primary Care Research Network (IPCRN) that will collect data on hospitalisations and prescribing from the practice's Socrates system and Healthlink messages.
It anonymises the data (e.g. removes names, dates of birth, addresses) before leaving the practice and is uploaded to the IPCRN and then is aggregated with other practice uploads. This method of data collection has previously been approved by the Data Protection Commissioner. The IPCRN then sends a report back to the practice giving a breakdown to the practice (and only the practice) of most common discharge diagnoses, patient profile, prescribing etc. This will be of use to the practice in terms of practice meetings on quality of clinical care, audit, planning and GPs’ CPD requirements. The data collection method is also very straight forward and requires little extra work from the practice.
If your practice uses Socrates and your primary hospital of referral is any of the following then you may be eligible to participate:
Galway: University Hospital Galway
Dublin: St James, Mater, Beaumont, Beacon, Tallaght (AMNCH)
A practice information leaflet, formal invitation letter and consent is available – please email the PI for same (predmond@rcsi.ie).
Prescribing quality at the transition from hospital to home is an important issue and this project will be an important step in better understanding and addressing this safety issue.