Prevalence of medication discrepancies in patients with cirrhosis: A pilot study

Kelly L. Hayward; Patricia C. Valery; W. Neil Cottrell; Katharine M. Irvine; Leigh U. Horsfall; Caroline J. Tallis; Veronique S. Chachay; Brittany J. Ruffin; Jennifer H. Martin; Elizabeth Powell

doi:10.1186/s12876-016-0530-4

Prevalence of medication discrepancies in patients with cirrhosis: A pilot study

Kelly L. Hayward, Patricia C. Valery, W. Neil Cottrell, Katharine M. Irvine, Leigh U. Horsfall, Caroline J. Tallis, Veronique S. Chachay, Brittany J. Ruffin, Jennifer H. Martin, Elizabeth Powell

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Abstract

Background: Cirrhosis patients are prescribed multiple medications for their liver disease and comorbidities. Discrepancies between medicines consumed by patients and those documented in the medical record may contribute to patient harm and impair disease management. The aim of the present study was to assess the magnitude and types of discrepancies among patient-reported and medical record-documented medications in patients with cirrhosis, and examine factors associated with such discrepancies.

Methods: Fifty patients who attended a hospital hepatology outpatient clinic were interviewed using a questionnaire composed of mixed short-response and multiple-choice questions. Patients' reported medication use was compared with documentation in the hospital medical records and pharmacy database. Medication adherence was assessed using the 8-question

Results: Twenty-seven patients (54.0 %) had ≥1 discrepancy between reported and documented medicines. Patients with ≥1 discrepancy were older (p=0.04) and multivariate analysis identified taking ≥5 conventional medicines or having a 'low' or 'medium' adherence ranking as independent predictors of discrepancy (adjusted OR 11.0 (95 % CI 1.8-67.4), 20.7 (95 % CI 1.3-337.7) and 49.0 (95 % CI 3.3-718.5) respectively). Concordance was highest for liver disease medicines (71.9 %) and lowest for complementary and alternative medicines (14.5 %) and respiratory medicines (0 %).

Conclusion: There is significant discrepancy between sources of patient medication information within the hepatology clinic. Medication reconciliation and medicines-management intervention may address the complex relationship between medication discrepancies, number of medications and patient adherence identified in this study.

Original language	English
Article number	114
Pages (from-to)	1-9
Number of pages	9
Journal	BMC Gastroenterology
Volume	16
DOIs	https://doi.org/10.1186/s12876-016-0530-4
Publication status	Published - 13 Sep 2016
Externally published	Yes

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Hayward, K. L., Valery, P. C., Cottrell, W. N., Irvine, K. M., Horsfall, L. U., Tallis, C. J., Chachay, V. S., Ruffin, B. J., Martin, J. H., & Powell, E. (2016). Prevalence of medication discrepancies in patients with cirrhosis: A pilot study. BMC Gastroenterology, 16, 1-9. [114]. https://doi.org/10.1186/s12876-016-0530-4

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title = "Prevalence of medication discrepancies in patients with cirrhosis: A pilot study",

abstract = "Background: Cirrhosis patients are prescribed multiple medications for their liver disease and comorbidities. Discrepancies between medicines consumed by patients and those documented in the medical record may contribute to patient harm and impair disease management. The aim of the present study was to assess the magnitude and types of discrepancies among patient-reported and medical record-documented medications in patients with cirrhosis, and examine factors associated with such discrepancies. Methods: Fifty patients who attended a hospital hepatology outpatient clinic were interviewed using a questionnaire composed of mixed short-response and multiple-choice questions. Patients' reported medication use was compared with documentation in the hospital medical records and pharmacy database. Medication adherence was assessed using the 8-questionResults: Twenty-seven patients (54.0 %) had ≥1 discrepancy between reported and documented medicines. Patients with ≥1 discrepancy were older (p=0.04) and multivariate analysis identified taking ≥5 conventional medicines or having a 'low' or 'medium' adherence ranking as independent predictors of discrepancy (adjusted OR 11.0 (95 % CI 1.8-67.4), 20.7 (95 % CI 1.3-337.7) and 49.0 (95 % CI 3.3-718.5) respectively). Concordance was highest for liver disease medicines (71.9 %) and lowest for complementary and alternative medicines (14.5 %) and respiratory medicines (0 %). Conclusion: There is significant discrepancy between sources of patient medication information within the hepatology clinic. Medication reconciliation and medicines-management intervention may address the complex relationship between medication discrepancies, number of medications and patient adherence identified in this study.",

keywords = "Ambulatory care, Complementary therapies, Liver cirrhosis, Medication adherence, Medication reconciliation",

author = "Hayward, {Kelly L.} and Valery, {Patricia C.} and Cottrell, {W. Neil} and Irvine, {Katharine M.} and Horsfall, {Leigh U.} and Tallis, {Caroline J.} and Chachay, {Veronique S.} and Ruffin, {Brittany J.} and Martin, {Jennifer H.} and Elizabeth Powell",

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doi = "10.1186/s12876-016-0530-4",

language = "English",

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journal = "BMC Gastroenterology",

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Prevalence of medication discrepancies in patients with cirrhosis : A pilot study. / Hayward, Kelly L.; Valery, Patricia C.; Cottrell, W. Neil; Irvine, Katharine M.; Horsfall, Leigh U.; Tallis, Caroline J.; Chachay, Veronique S.; Ruffin, Brittany J.; Martin, Jennifer H.; Powell, Elizabeth.

In: BMC Gastroenterology, Vol. 16, 114, 13.09.2016, p. 1-9.

Research output: Contribution to journal › Article

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T1 - Prevalence of medication discrepancies in patients with cirrhosis

T2 - A pilot study

AU - Hayward, Kelly L.

AU - Valery, Patricia C.

AU - Cottrell, W. Neil

AU - Irvine, Katharine M.

AU - Horsfall, Leigh U.

AU - Tallis, Caroline J.

AU - Chachay, Veronique S.

AU - Ruffin, Brittany J.

AU - Martin, Jennifer H.

AU - Powell, Elizabeth

PY - 2016/9/13

Y1 - 2016/9/13

N2 - Background: Cirrhosis patients are prescribed multiple medications for their liver disease and comorbidities. Discrepancies between medicines consumed by patients and those documented in the medical record may contribute to patient harm and impair disease management. The aim of the present study was to assess the magnitude and types of discrepancies among patient-reported and medical record-documented medications in patients with cirrhosis, and examine factors associated with such discrepancies. Methods: Fifty patients who attended a hospital hepatology outpatient clinic were interviewed using a questionnaire composed of mixed short-response and multiple-choice questions. Patients' reported medication use was compared with documentation in the hospital medical records and pharmacy database. Medication adherence was assessed using the 8-questionResults: Twenty-seven patients (54.0 %) had ≥1 discrepancy between reported and documented medicines. Patients with ≥1 discrepancy were older (p=0.04) and multivariate analysis identified taking ≥5 conventional medicines or having a 'low' or 'medium' adherence ranking as independent predictors of discrepancy (adjusted OR 11.0 (95 % CI 1.8-67.4), 20.7 (95 % CI 1.3-337.7) and 49.0 (95 % CI 3.3-718.5) respectively). Concordance was highest for liver disease medicines (71.9 %) and lowest for complementary and alternative medicines (14.5 %) and respiratory medicines (0 %). Conclusion: There is significant discrepancy between sources of patient medication information within the hepatology clinic. Medication reconciliation and medicines-management intervention may address the complex relationship between medication discrepancies, number of medications and patient adherence identified in this study.

AB - Background: Cirrhosis patients are prescribed multiple medications for their liver disease and comorbidities. Discrepancies between medicines consumed by patients and those documented in the medical record may contribute to patient harm and impair disease management. The aim of the present study was to assess the magnitude and types of discrepancies among patient-reported and medical record-documented medications in patients with cirrhosis, and examine factors associated with such discrepancies. Methods: Fifty patients who attended a hospital hepatology outpatient clinic were interviewed using a questionnaire composed of mixed short-response and multiple-choice questions. Patients' reported medication use was compared with documentation in the hospital medical records and pharmacy database. Medication adherence was assessed using the 8-questionResults: Twenty-seven patients (54.0 %) had ≥1 discrepancy between reported and documented medicines. Patients with ≥1 discrepancy were older (p=0.04) and multivariate analysis identified taking ≥5 conventional medicines or having a 'low' or 'medium' adherence ranking as independent predictors of discrepancy (adjusted OR 11.0 (95 % CI 1.8-67.4), 20.7 (95 % CI 1.3-337.7) and 49.0 (95 % CI 3.3-718.5) respectively). Concordance was highest for liver disease medicines (71.9 %) and lowest for complementary and alternative medicines (14.5 %) and respiratory medicines (0 %). Conclusion: There is significant discrepancy between sources of patient medication information within the hepatology clinic. Medication reconciliation and medicines-management intervention may address the complex relationship between medication discrepancies, number of medications and patient adherence identified in this study.

KW - Ambulatory care

KW - Complementary therapies

KW - Liver cirrhosis

KW - Medication adherence

KW - Medication reconciliation

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