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LYNE LALONDE, PH.D., is Associate Professor; and MARIE-CLAUDE VANIER, M.SC., is Associate Clinical Professor, Faculty of Pharmacy, University of Montreal, Quebec, Canada. ANNE-MARIE LAMPRON, M.SC., is Pharmacist, Centre de Sante et de Services Sociaux du Nord Launaudiere, Centre Hospitalier Regional de Lanaudiere, Quebec. PATRICK LEVASSEUR, M.SC., BCPS, is Pharmacist, Centre de Sante et de Services Sociaux de Laval, Quebec. RIMA KHADDAG, M.SC., is Pharmacist, Pharmacie Pierrot Lebrun, Quebec; and NESRINE CHAAR, M.SC., is Pharmacist, Hopital General de Montreal, Quebec.

Address correspondence to Dr. Lalonde, Faculty of Pharmacy, University of Montreal, C.P. 6128, Succursale Centreville, Montreal, Quebec H3C 317, Canada (lyne.lalonde{at}umontreal.ca).

Purpose. The effect of a medication discharge plan (MDP) on the rate of medication discrepancies between hospital and outpatient settings was evaluated. Methods. In a pragmatic, open, randomized, controlled trial, MDPs were completed for all patients before discharge from the hospital. Patients were then assigned to either an MDP group, for whom MDPs were sent to community pharmacies and treating physicians, or a usual care group, for whom an MDP was not sent. Discrepancies between MDPs and community pharmacy dispensing records and medication use reported by patients during a telephone interview were documented. The percentage of patients with discrepancies and the mean percentage of medications with discrepancies were compared between the two groups. The clinical severity of discrepancies was blindly evaluated. Results. A total of 83 patients agreed to participate in the study. The percentage of patients with at least one discrepancy was high and similar in both groups when MDPs were compared with pharmacy dispensing records and patient self-reports. Comparison of MDPs to pharmacy dispensing records revealed discrepancies for 13–15% of medications; more than a third were clinically significant. Comparison of MDPs to patient self-reports revealed discrepancies for 10–12% of medications; 48% were clinically significant. No significant differences were observed between the two groups. Conclusion. The rate of medication discrepancies was not decreased in patients whose MDP was provided to their community pharmacy and physician at the time of hospital discharge compared with the rate in patients who received usual care. Index terms: Errors, medication; Hospitals; Patient care; Patients; Toxicity

 

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