Inappropriate Prescribing: A Reminder

In 2017 the World Health Organization launched its third global patient safety challenge with the aim of reducing severe avoidable medication-related harm by 50% over a five year period. See Medication Without Harm

Demonstrating success in achieving this may be difficult, but countries such as the UK are in a strong position to meet the spirit of this challenge because we have strong integration of our healthcare systems and electronic health records which we could probably use more effectively.

A very important approach is to identify potentially inappropriate prescribing and correct it where necessary, with the expectation that intervening will avoid serious harm. Yet, around half of older patients are exposed to potentially inappropriate prescribing each year and hospitalisation puts them at an increased risk, a new study conducted in Eire shows.

See: https://www.bmj.com/content/363/bmj.k4524

The authors of this study point out that medicines management services for inpatients in Ireland are broadly similar to those in the UK.

Their finding is worrying because inpatient admissions can provide the opportunity for specialist teams to review and optimise management of older patients’ chronic conditions, including their drugs. So, although hospital admissions have the potential to improve management of drugs, this study suggests that the possible benefit of more appropriate prescribing after discharge to primary care is not being realised.

Something somewhere seems to be going wrong. The authors suggest that improving coordination of transitional care (hospital to home and vice versa) particularly for older patients with complex care needs has the potential to reduce mortality, hospital readmissions, and the number of readmissions. Time to look again I think at the UK’s electronic drug management systems and the organisation of discharges from hospitals.

Why is it so difficult to get an electronic summary care record from A to B in order to reduce discrepancies arising from transitions between hospital and primary care?

This is not a new problem its an old one but surely one that could be tackled and eradicated now

 

 

 

 

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