A quality improvement study on the effect of electronic transmission of a basic discharge medication report on medication discrepancies in patients discharged from the hospital

Background: Medication discrepancies can occur in transitions of care because of a lack of communication between hospitals and community pharmacies. These discrepancies can lead to preventable adverse drug events (ADEs). 

Aim: To investigate the effect of electronic transmission of the basic discharge medication report on unintentional medication discrepancies observed between this report and the 28-day post-discharge status in the community pharmacy. \

Method: The study took place in a Dutch teaching hospital and 8 community pharmacies. A quality improvement study with a nonrandomized, historically controlled intervention design was performed. The intervention consisted of the electronic transmission of a basic discharge medication report to the community pharmacies. Unintentional medication discrepancies were identified by comparing the basic discharge medication report to the 28-day post-discharge medication record in community pharmacies. The main outcome measure was the proportion of drugs with one or more unintentional discrepancies compared between the historical control group and intervention group, using the chi-square test. Secondary outcome measure was the proportion of patients with one or more unintentional discrepancies. 

Results: The participants used a total of 1078 drugs in the control group and 862 in the intervention group. The intervention significantly reduced the proportion of drugs with an unintentional discrepancy from 230 out of 1078 in the control group (21.3%) to 149 out of 862 drugs in the intervention group (17.3%; p = 0.025). At patient level, a non-significant increase was seen (62.4–78.8%; p = 0.41). 

Conclusion: The electronic transmission of the basic discharge medication report reduced the proportion of drugs with an unintentional discrepancy after discharge, but not the proportion of patients.