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Medication Discrepancy Risk Factors the #1 Factor: Low Social Support

The Bad News:
Despite much attention in recent decades, medication discrepancies still present a prevalent danger for patients. Across various care settings and patient groups, the prevalence of medication discrepancies has ranged from 14% to 86%. (1-5)

One of the latest entries into this body of evidence is the work of Elizabeth Manias and colleagues, measuring an unintentional medication discrepancy rate of 39.7%. (6) Among these patients with medication discrepancies, 68% were readmitted to the hospital within six months. Interestingly, Manias and colleagues examined their data to reveal risk factors for medication discrepancies. Knowing these risk factors can help with care planning.

In the current study, researchers examined the medical records of 426 patients, age 65+, who were admitted to any of five hospitals through the emergency department. They followed the patients across various acute and subacute care settings and through to discharge to home. Their data established the following risk factors for unexplained medication discrepancies:

• No Social Support: This increased the risk 171%. This was defined as having no partner, informal caregiver, or formal caregiver.
• Multiple Transitions: Transitions here refers to care settings such as the ED, cardiac ward, intensive care, nursing home, etc. More than four transition points increased the odds 148%.
• Multiple Pre-Existing Prescriptions: Each prescription that was already in place at presentation to the ED increased the risk 13%.

No social support turned out to be the largest modifiable risk factor in medication discrepancies. The presence of a risk factor can serve as a red flag that additional support may be warranted.

The Good News:
When patients need improved social support, doctors, discharge planners and families can recommend private duty home care. The private-duty home care and nursing available through McKenney Home Care can provide the social support needed to modify this risk factor as well as skilled nursing for at-home medication reconciliation. Adding a home visit to the medication reconciliation program detects 62% more medication discrepancies – even after pre-discharge medication reconciliation and post-discharge reconciliation by phone.(7)

When you refer patients or loved ones with potential medication adherence problems, McKenney Home Care can send nursing assistants to provide medication reminders and assist with self administered medication. McKenney aides can pick up medications for clients at the pharmacy, examine medication containers to evaluate adherence, and report adherence problems to nurse supervisors for further interventions.

If forgetfulness, impaired judgment, or physical limitations are impeding your patients’ ability to adhere to their medication instructions, it is highly likely that other health-related activities of daily living are suffering. Order an in-home assessment by McKenney Home Care to help ensure that all your patient’s needs are being met, so elderly patients can stay in their own homes with greater convenience, safety, and health.

McKenney Home Care in Naples, FL hosts a Lewy Body Dementia Support Group on the first Wednesday of every month.  This ongoing support group is approved by the Lewy Body Dementia Association in Atlanta and is in affiliation with the Parkinson’s Association of SWFL and the Alzheimer’s Support Network.

McKenney Home Care provides exceptional in-home health services and client-centered care. With a passion for maximizing the quality of life of their clients and their families, they are driven to ensure social engagement and specialty services during all stages of life.

For Individuals with neurodegenerative disorders, McKenney Home Care delivers enriched specialized training for its caregivers working with Dementia Patients. In addition to specialized videos and manuals, McKenney educates the caregivers through the use of the Virtual Alzheimer’s App. This virtual reality experience helps caregivers understand the feelings and experience of those suffering from Alzheimer’s and other forms of Dementia.

Along with their medical expertise, McKenney Home Care is a certified Music & Memory Agency. Providing help for Dementia Patients; this specialized music therapy program is highly personalized and has been shown to reduce the need for anti-anxiety and antipsychotic drugs by up to 50%, while brining joy to the lives of patients who have Dementia.

If you or someone you know would like more information about McKenney Home Care or the LBD Support Group, please call McKenney Home Care at 239-325-2273, or visit mckenneyhomecare.com.

References:
1. Kee KW, Char CW, Yip AY. A review on interventions to reduce medication discrepancies or errors in primary or ambulatory care setting during care transition from hospital to primary care. Journal of Family Medicine and Primary Care. 2018 May;7(3):501.
2. Azzi M, Constantino M, Pont L, Mcgill M, Twigg S, Krass I. Medication safety: an audit of medication discrepancies in transferring type 2 diabetes mellitus (T2DM) patients from Australian primary care to tertiary ambulatory care. International Journal for Quality in Health Care. 2014 May 19;26 (4):397-403.
3. Coleman EA, Smith JD, Raha D, Min SJ. Post hospital medication discrepancies: prevalence and contributing factors. Archives of Internal Medicine. 2005 Sep 12; 165 (16): 1842-7.
4. Manias E, Gerdtz MF, Weiland TJ, Collins M. Medication use across transition points from the emergency department: identifying factors associated with medication discrepancies. Annals of Pharmacotherapy. 2009 Nov;43 (11):1755-64.
5. Wong JD, Bajcar JM, Wong GG, Alibhai SM, Huh JH, Cesta A, Pond GR, Fernandes OA. Medication reconciliation at hospital discharge: evaluating discrepancies. Annals of Pharmacotherapy. 2008 Oct; 42 (10):1373-9.
6. Manias E, Annakis N, Considine J, Weerasuriya R, Kusljic S. Patient-, medication-and environment-related factors affecting medication discrepancies in older patients. Collegian. 2017 Dec 1;24 (6):571-7. 7. Costa L, Poe S. Challenges in post hospital care: nurses as coaches for medication management. J Nurs Care Qual. 2011; 26 (3): 243-251.
7. Costa L, Poe S. Challenges in post hospital care: nurses as coaches for medication management. J Nurs Care Qual. 2011; 26 (3): 243-251.

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