A recent study has shed light on a critical issue affecting patient care during transitions from hospitals to residential aged-care facilities (RACFs). The research reveals that nearly a quarter of patients experience missed or delayed medication doses, which can have serious implications for their health and well-being.
Led by Adjunct Assoc Prof Rohan Elliott from Austin Health's Pharmacy Department, the team reviewed cases of 397 patients across 11 Victorian hospitals, just two days after their discharge. The findings are eye-opening: 23% of patients had missed or delayed doses, with some missing high-risk medications like opioids and insulin.
But here's where it gets controversial: the study suggests that certain practices can reduce these risks. For instance, providing discharge medications in their original packaging and an interim medication administration chart (IMAC) can help. However, only 52% of patients had their aged-care medication charts prepared or updated on the day of transfer, and just 46% received updated medications from their community pharmacy.
And this is the part most people miss: having a GP or locum create the RACF medication charts on the day of discharge actually increased the risk of missed doses. Why? Likely because GPs are often unavailable until later in the day.
The researchers recommend encouraging and supporting hospitals to provide IMACs, and RACFs to use them routinely. However, they point to a lack of clear guidance and support from state and Commonwealth governments, and a lack of standardization of IMAC procedures, as major barriers.
With a median time of less than three hours between discharge and the first required medication dose, the team also suggests allowing hospitals to provide up to seven days' worth of interim medication supply, aligned with a seven-day IMAC, to ensure continuity of care.
So, what do you think? Are these recommendations enough to address the barriers to continuity of medication? Or do we need more innovative solutions? We'd love to hear your thoughts in the comments!
