Frequency and predictors of prescription-related issues after hospital discharge

J Hosp Med. 2008 Jan;3(1):12-9. doi: 10.1002/jhm.248.

Abstract

Background: In the period immediately following hospital discharge, patients often experience difficulty with medication management. The problems related to patients' handling of discharge prescriptions are not well characterized.

Methods: We conducted a large observational study of patients discharged from 170 community hospitals in 2005. By combining clinical, administrative, and call center data, we were able to examine independent predictors of prescription-related issues in the 48-72 hours after hospital discharge. Issues included: not picking up prescribed discharge medications, not knowing if these medications had been picked up, not taking discharge medications, and not understanding how to take the medications.

Results: More than half (57.0%) of the 31,199 subjects in the study were women, and the mean age was 61.1 years. Overall, 7.2% of patients (n = 2253) reported prescription-related issues, most often not filling discharge prescriptions. In multivariable analyses, prescription-related issues were more common among adults age 35-49; women; patients with Medicare HMO coverage, Medicaid, or no insurance; adults with higher severity of illness ratings; and patients prescribed 6 or more medications or an inhaler. Predictors of fewer problems were being age 65 or older; having HMO or commercial insurance; being prescribed antibiotics, anticoagulants, or angiotensin II receptor blockers; and having a major diagnosis in the skin or musculoskeletal categories.

Conclusions: About 7% of patients reported prescription-related issues within a few days of hospital discharge. High-risk patients should be identified and offered additional assistance prior to discharge and receive a follow-up phone call to assess if discharge prescriptions have been filled.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Diagnosis-Related Groups
  • Drug Prescriptions*
  • Female
  • Hospital Records
  • Hospitals, Community
  • Humans
  • Insurance, Health
  • Interviews as Topic
  • Length of Stay
  • Logistic Models
  • Male
  • Middle Aged
  • Observation
  • Odds Ratio
  • Patient Compliance / psychology*
  • Patient Compliance / statistics & numerical data
  • Patient Discharge / standards*
  • Self Administration / psychology*
  • Self Administration / statistics & numerical data
  • Severity of Illness Index
  • Sex Factors
  • United States