This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (71)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Aging/ Geriatrics  • Treatment Adherence  • Adherence  • Medication Error  • Alert me on articles by topic  Social Bookmarking   What's this?

Their Extent and Predictors in an Outpatient Practice

Susanna E. Bedell, MD; Samer Jabbour, MD, MPH; Robert Goldberg, PhD; Helene Glaser, RN; Susan Gobble, MBA; Yinong Young-Xu, MA; Thomas B. Graboys, MD; Shmuel Ravid, MD

Arch Intern Med. 2000;160:2129-2134.

Background  Misuse of medications is a major cause of morbidity and mortality. Few studies have examined the frequency of, and factors associated with, discrepancies between what doctors prescribe and what patients take in actual practice.

Patients and Methods  Patients' medication bottles and their reported use of medications were compared with physicians' records of outpatients seen between November 1997 and February 1998 in a private practice affiliated with an academic medical center in Boston, Mass. Three hundred twelve patients from the practices of 5 cardiologists and 2 internists who were returning for their routine follow-up visits were included.

Main Outcome Measure  The presence of discrepancies based on comparing medication bottles with medical records.

Results  Discrepancies were present in 239 patients (76%). The 545 discrepancies in these patients were the result of patients taking medications that were not recorded (n = 278 [51%]); patients not taking a recorded medication (n = 158 [29%]); and differences in dosage (n = 109 [20%]). Overall, discrepancies were randomly distributed among different drugs and discrepancy types with no discernible pattern. On multivariate analysis, patient age and number of recorded medications were the 2 most significant predictors of medication discrepancy.

Conclusions  Discrepancies among recorded and reported medications were common and involved all classes of medications, including cardiac and prescription drugs. Older age and polypharmacy were the most significant correlates of discrepancy. The pervasiveness of discrepancies can have significant health care implications, and action is urgently needed to address their causes. Such action would likely have a positive impact on patient care.

From Lown Cardiovascular Center, Brookline, Mass (Drs Bedell, Jabbour, Graboys, and Ravid, Ms Glaser, and Mr Young-Xu); The Department of Medicine, Harvard Medical School (Drs Bedell, Jabbour, Graboys, and Ravid), and the Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School (Dr Goldberg), Boston; and the Department of Medicine, Memorial Health Services, Long Beach, Calif (Ms Gobble).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The Patient Medication List: Can We Get Patients More Involved in Their Medical Care?
Chae et al.
J Am Board Fam Med 2009;22:677-685.
ABSTRACT | FULL TEXT  

Medication Use Across Transition Points from the Emergency Department: Identifying Factors Associated with Medication Discrepancies
Manias et al.
The Annals of Pharmacotherapy 2009;43:1755-1764.
ABSTRACT | FULL TEXT  

Medication reconciliation in ambulatory care: attempts at improvement
Nassaralla et al.
Qual Saf Health Care 2009;18:402-407.
ABSTRACT | FULL TEXT  

Interventions to Improve Medication Reconciliation in Primary Care
Bayoumi et al.
The Annals of Pharmacotherapy 2009;43:1667-1675.
ABSTRACT | FULL TEXT  

Effect of Medication Reconciliation With and Without Patient Counseling on the Number of Pharmaceutical Interventions Among Patients Discharged from the Hospital
Karapinar-Carkit et al.
The Annals of Pharmacotherapy 2009;43:1001-1010.
ABSTRACT | FULL TEXT  

Standardized care processes to improve quality and safety of patient care in a large academic practice: the Plummer Project of the Department of Medicine, Mayo Clinic
Wood et al.
Health Serv Manage Res 2008;21:276-280.
ABSTRACT | FULL TEXT  

HIV and hepatitis B/C infections in patients donating blood for use as autologous serum eye drops
Weisbach et al.
Br J Ophthalmol 2007;91:1724-1725.
FULL TEXT  

Are Patients Reliable When Self-Reporting Medication Use? Validation of Structured Drug Interviews and Home Visits by Drug Analysis and Prescription Data in Acutely Hospitalized Patients
Glintborg et al.
J Clin Pharmacol 2007;47:1440-1449.
ABSTRACT | FULL TEXT  

Implementation of a medication reconciliation process in an ambulatory internal medicine clinic
Nassaralla et al.
Qual Saf Health Care 2007;16:90-94.
ABSTRACT | FULL TEXT  

Use of pictorial aids in medication instructions: A review of the literature
Katz et al.
Am J Health Syst Pharm 2006;63:2391-2397.
ABSTRACT | FULL TEXT  

Pharmacy Clarification of Prescriptions Ordered in Primary Care: A Report from the Applied Strategies for Improving Patient Safety (ASIPS) Collaborative
Hansen et al.
J Am Board Fam Med 2006;19:24-30.
ABSTRACT | FULL TEXT  

Posthospital Medication Discrepancies: Prevalence and Contributing Factors
Coleman et al.
Arch Intern Med 2005;165:1842-1847.
ABSTRACT | FULL TEXT  

Treatment of Type 2 Diabetes in Primary Health Care: A Drug Utilization Study
Mino-Leon et al.
The Annals of Pharmacotherapy 2005;39:441-445.
ABSTRACT | FULL TEXT  

Patient-Reported Medication Symptoms in Primary Care
Weingart et al.
Arch Intern Med 2005;165:234-240.
ABSTRACT | FULL TEXT  

Lessons from a patient partnership intervention to prevent adverse drug events
Weingart et al.
Int J Qual Health Care 2004;16:499-507.
ABSTRACT | FULL TEXT  

Interdisciplinary Approach to Teaching Medication Adherence to Pharmacy and Osteopathic Medical Students
Singla et al.
JAOA: Journal of the American Osteopathic Association 2004;104:127-132.
ABSTRACT | FULL TEXT  

Long-term statin use and psychological well-being
Young-Xu et al.
J Am Coll Cardiol 2003;42:690-697.
ABSTRACT | FULL TEXT  

Improving Adherence and Reducing Medication Discrepancies in Patients with Diabetes
Grant et al.
The Annals of Pharmacotherapy 2003;37:962-969.
ABSTRACT | FULL TEXT  

Medication Errors in Acute Cardiac Care: An American Heart Association Scientific Statement From the Council on Clinical Cardiology Subcommittee on Acute Cardiac Care, Council on Cardiopulmonary and Critical Care, Council on Cardiovascular Nursing, and Council on Stroke
Freedman et al.
Circulation 2002;106:2623-2629.
FULL TEXT  

Inappropriate Drug Prescribing in Home-Dwelling, Elderly Patients: A Population-Based Survey
Pitkala et al.
Arch Intern Med 2002;162:1707-1712.
ABSTRACT | FULL TEXT  

Prevention of Glucocorticoid-Induced Osteoporosis: Experience in a Managed Care Setting
Yood et al.
Arch Intern Med 2001;161:1322-1327.
ABSTRACT | FULL TEXT