Medication issues experienced by patients and carers after discharge from the intensive care unit

Abstract Purpose Medication-related problems (MRPs) frequently occur at the interfaces of care settings. We examined this further because little has been published about MRPs experienced by patients/carers after discharge from the intensive care unit (ICU). Methods and Materials Medication history d...

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Bibliographic Details
Published in:Journal of critical care 2013-02, Vol.28 (1), p.46-50
Main Authors: Eijsbroek, Heleen, Howell, David C.J., BSc, MBBS, FRCP, PhD, Smith, Felicity, BPharm, MA, PhD, MRPharmS, Shulman, Rob, BScPharm(Hons), DHC(Pharm), MRPharmS, ClinDipPharm
Format: Article
Language:English
Subjects:
Adult
Attitude to Health
Caregivers
Carers
Continuity of Patient Care
Critical Care
Drug therapy
Female
Humans
Intensive care
Intensive Care Units
Interviews
Interviews as Topic
Male
Medical errors
Medication problems
Medication Reconciliation
Medicine
Medicines reconciliation
Middle Aged
Netherlands
Patient Discharge
Patient perspectives
Patients
Pharmacy
Polypharmacy
Reconciliation
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Summary:Abstract Purpose Medication-related problems (MRPs) frequently occur at the interfaces of care settings. We examined this further because little has been published about MRPs experienced by patients/carers after discharge from the intensive care unit (ICU). Methods and Materials Medication history data were collected before, during, and after ICU admission and by face-to-face semistructured interviews with 21 patients and 13 carers attending the ICU Follow-up Clinic (FC) of our 35-bed adult ICU. Results A total of 122 drugs were prescribed regularly before ICU admission, 168 on ICU discharge, 132 at hospital discharge, and 128 at the FC. Medication-related problems were identified with hypnotics/anxiolytics, antidepressants, proton pump inhibitors, and analgesics. Good follow-up was observed in all 4 cases where the antidysrhythmic agent amiodarone was initiated on ICU. Patients/carers described 20 cases of difficulty in obtaining appropriate and timely supplies and 19 of insufficient information. Conclusions These results show that our incidence of MRPs after ICU discharge was encouragingly infrequent, in which we attribute it to targeted medicine reconciliation and the availability of our FC. However, MRPs were perceived to stem from inadequate communication at the interfaces of care and the lack of opportunity for patients/carers to obtain relevant information. We recommend that FC should focus on MRPs during their consultation and that further research in this area should be performed to examine our observations further.
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2012.06.002