Uncovering a multitude of sins : medication management in the home post acute hospitalisation among the chronically ill.
Sub-optimal use of prescribed medication is often associated with unplanned hospitalisation among the chronically ill.
To examine the extent of sub-optimal use of prescribed medication in a'high risk'patient cohort recently discharged from acute hospital care.
Chronically ill patients discharged from acute hospital care (n=342) were studied.
At one week post discharge a home visit was performed by a nurse and a pharmacist during which medication management (including compliance and medication-related knowledge) was assessed.
During the majority of home visits at least one medication-related problem was detected : approximately half of the cohort subject to a'reliable'pill-count were found to be mal-compliant and almost all demonstrated inadequate medication-related knowledge.
Mal-compliance was correlated with >= five prescribed medications (Odds ratio [OR] 2.6 : p<0.002).
Comparatively, lower medication-related knowledge was correlated with age>75 years (OR 2.2 : p<0.001), exacerbation of a pre-existing chronic illness (OR 2.7 : p=0.044) and <= six years formal education (OR 1.9 : p=0.004).
Neither were modulated by extent of in-hospital counselling.
Other previously unknown problems detected during the home visit included hoarding of previously prescribed medication (35%) and reducing medication intake to minimise costs (21%). (...)
Mots-clés Pascal : Malade, Chronicité, Prescription médicale, Sortie hôpital, Etude comparative, Observance médicamenteuse, Education santé, Dose, Effet secondaire, Australie, Océanie, Adulte, Homme, Personne âgée
Mots-clés Pascal anglais : Patient, Chronicity, Medical prescription, Hospital discharge, Comparative study, Drug compliance, Health education, Dose, Secondary effect, Australia, Oceania, Adult, Human, Elderly
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0270885
Code Inist : 002B30A11. Création : 16/11/1999.