PURPOSE: Medication-related problems (MRPs) frequently occur at the interfaces of care settings. We examined this further because little has been published about MRPs experienced by patients/carers after discharge from the intensive care unit (ICU). METHODS AND MATERIALS: Medication history data were collected before, during, and after ICU admission and by face-to-face semistructured interviews with 21 patients and 13 carers attending the ICU Follow-up Clinic (FC) of our 35-bed adult ICU. RESULTS: A total of 122 drugs were prescribed regularly before ICU admission, 168 on ICU discharge, 132 at hospital discharge, and 128 at the FC. Medication-related problems were identified with hypnotics/anxiolytics, antidepressants, proton pump inhibitors, and analgesics. Good follow-up was observed in all 4 cases where the antidysrhythmic agent amiodarone was initiated on ICU. Patients/carers described 20 cases of difficulty in obtaining appropriate and timely supplies and 19 of insufficient information. CONCLUSIONS: These results show that our incidence of MRPs after ICU discharge was encouragingly infrequent, in which we attribute it to targeted medicine reconciliation and the availability of our FC. However, MRPs were perceived to stem from inadequate communication at the interfaces of care and the lack of opportunity for patients/carers to obtain relevant information. We recommend that FC should focus on MRPs during their consultation and that further research in this area should be performed to examine our observations further.
PURPOSE: Medication-related problems (MRPs) frequently occur at the interfaces of care settings. We examined this further because little has been published about MRPs experienced by patients/carers after discharge from the intensive care unit (ICU). METHODS AND MATERIALS: Medication history data were collected before, during, and after ICU admission and by face-to-face semistructured interviews with 21 patients and 13 carers attending the ICU Follow-up Clinic (FC) of our 35-bed adult ICU. RESULTS: A total of 122 drugs were prescribed regularly before ICU admission, 168 on ICU discharge, 132 at hospital discharge, and 128 at the FC. Medication-related problems were identified with hypnotics/anxiolytics, antidepressants, proton pump inhibitors, and analgesics. Good follow-up was observed in all 4 cases where the antidysrhythmic agent amiodarone was initiated on ICU. Patients/carers described 20 cases of difficulty in obtaining appropriate and timely supplies and 19 of insufficient information. CONCLUSIONS: These results show that our incidence of MRPs after ICU discharge was encouragingly infrequent, in which we attribute it to targeted medicine reconciliation and the availability of our FC. However, MRPs were perceived to stem from inadequate communication at the interfaces of care and the lack of opportunity for patients/carers to obtain relevant information. We recommend that FC should focus on MRPs during their consultation and that further research in this area should be performed to examine our observations further.
Authors: Henry T Stelfox; Jaime Bastos; Daniel J Niven; Sean M Bagshaw; T C Turin; Song Gao Journal: Intensive Care Med Date: 2015-12-22 Impact factor: 17.440
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Authors: Bertha Elizabeth Bosma; Edmé Meuwese; Siok Swan Tan; Jasper van Bommel; Piet Herman Gerard Jan Melief; Nicole Geertruida Maria Hunfeld; Patricia Maria Lucia Adriana van den Bemt Journal: BMC Health Serv Res Date: 2017-02-10 Impact factor: 2.655
Authors: Pamela MacTavish; Tara Quasim; Martin Shaw; Helen Devine; Malcolm Daniel; John Kinsella; Carl Fenelon; Rakesh Kishore; Theodore J Iwashyna; Joanne McPeake Journal: BMJ Open Qual Date: 2019-09-27
Authors: Liesbeth B E Bosma; Nicole G M Hunfeld; Rogier A M Quax; Edmé Meuwese; Piet H G J Melief; Jasper van Bommel; SiokSwan Tan; Maaike J van Kranenburg; Patricia M L A van den Bemt Journal: Ann Intensive Care Date: 2018-02-07 Impact factor: 6.925