Federica Edith Pisa1,2, Francesca Palese3, Federico Romanese3, Fabio Barbone3, Giancarlo Logroscino4, Oliver Riedel1. 1. Clinical Epidemiology Department, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany. 2. Institute of Hygiene and Clinical Epidemiology, University Hospital of Udine, Udine, Italy. 3. Department of Medicine, University of Udine, Udine, Italy. 4. Neurodegenerative Diseases Unit, Department of Basic Medicine Neuroscience and Sense Organs, Department of Clinical Research in Neurology of the University of Bari at "Pia Fondazione Card. G. Panico" Hospital Tricase, Lecce, University of Bari, Lecce, Italy.
Abstract
OBJECTIVES: Reliable information on preadmission medications is essential for inpatients with dementia, but its quality has hardly been evaluated. We assessed the completeness of information and factors associated with incomplete recording. METHODS: We compared preadmission medications recorded in hospital electronic medical records (EMRs) with community-pharmacy dispensations in hospitalizations with discharge code for dementia at the University Hospital of Udine, Italy, 2012-2014. We calculated: (a) prevalence of omissions (dispensed medication not recorded in EMRs), additions (medication recorded in EMRs not dispensed), and discrepancies (any omission or addition); (b) multivariable logistic regression odds ratio, with 95% confidence interval (95% CI), of ≥1 omission. RESULTS: Among 2,777 hospitalizations, 86.1% had ≥1 discrepancy for any medication (Kappa 0.10) and 33.4% for psychotropics. When psychotropics were recorded in EMR, antipsychotics were added in 71.9% (antidepressants: 29.2%, antidementia agents: 48.2%); when dispensed, antipsychotics were omitted in 54.4% (antidepressants: 52.7%, antidementia agents: 41.5%). Omissions were 92% and twice more likely in patients taking 5 to 9 and ≥10 medications (vs. 0 to 4), 17% in patients with psychiatric disturbances (vs. none), and 41% with emergency admission (vs. planned). CONCLUSION: Psychotropics, commonly used in dementia, were often incompletely recorded. To enhance information completeness, both EMRs and dispensations should be used.
OBJECTIVES: Reliable information on preadmission medications is essential for inpatients with dementia, but its quality has hardly been evaluated. We assessed the completeness of information and factors associated with incomplete recording. METHODS: We compared preadmission medications recorded in hospital electronic medical records (EMRs) with community-pharmacy dispensations in hospitalizations with discharge code for dementia at the University Hospital of Udine, Italy, 2012-2014. We calculated: (a) prevalence of omissions (dispensed medication not recorded in EMRs), additions (medication recorded in EMRs not dispensed), and discrepancies (any omission or addition); (b) multivariable logistic regression odds ratio, with 95% confidence interval (95% CI), of ≥1 omission. RESULTS: Among 2,777 hospitalizations, 86.1% had ≥1 discrepancy for any medication (Kappa 0.10) and 33.4% for psychotropics. When psychotropics were recorded in EMR, antipsychotics were added in 71.9% (antidepressants: 29.2%, antidementia agents: 48.2%); when dispensed, antipsychotics were omitted in 54.4% (antidepressants: 52.7%, antidementia agents: 41.5%). Omissions were 92% and twice more likely in patients taking 5 to 9 and ≥10 medications (vs. 0 to 4), 17% in patients with psychiatric disturbances (vs. none), and 41% with emergency admission (vs. planned). CONCLUSION: Psychotropics, commonly used in dementia, were often incompletely recorded. To enhance information completeness, both EMRs and dispensations should be used.
Authors: O Turró-Garriga; L Calvó-Perxas; R Albaladejo; E Alsina; J M Cuy; J Llinàs-Reglà; A M Roig; J Serena; N Vallmajó; M Viñas; S López-Pousa; J Vilalta-Franch; J Garre-Olmo Journal: Arch Gerontol Geriatr Date: 2015-02-07 Impact factor: 3.250
Authors: Terri L Warholak; Matthew McCulloch; Alysson Baumgart; Mindy Smith; William Fink; William Fritz Journal: J Manag Care Pharm Date: 2009 Nov-Dec
Authors: O Riedel; A Emmrich; J Klotsche; R Dodel; H Förstl; W Maier; H Reichmann; H-U Wittchen Journal: Dement Geriatr Cogn Dis Extra Date: 2012-11-08