What should you do if you are confused about the medicines you were told to take when you get home from the hospital?

Medication discrepancies after discharge are common and can lead to patient confusion and harm.^1-2 One study found that 81% of patients had no understanding of at least one medication change (new dosing or reasons for change in meds) or experienced provider error on discharge medications.³ Adverse drug events due to medication discrepancies after discharge are common and lead to serious patient harm.  A randomized trial of 851 patients discharged from two large academic hospitals found that within 30 days after discharge, 432 (50.8%) had one or more clinically important medication errors; 23% of such errors were judged to be serious and 2% life-threatening.⁴ Another study reported that adverse drug events were the most common type of adverse events reported in the post-discharge period.⁵ A recent large study of readmitted patients found that one reason for preventable readmissions was patient lack of awareness of who to contact after discharge.⁶ Providing patients with a phone number of who to call when they are confused or need help after discharge is a strategy that might help decrease readmissions and reduce patient harm.

^References

1. Cua YM, Kripalani S. Medication use in the transition from hospital to home. Ann Acad Med Singapore. 2008;37(2):136-6.
2. Kripalani S, Jackson AT, Schnipper JL, Coleman EA. Promoting effective transitions of care at hospital discharge: a review of key issues for hospitalists. J Hosp Med. 2007;2(5):314-23.
3. Ziaeian B, Araujo KL, Van Ness PH, Horwitz LI. Medication reconciliation accuracy and patient understanding of intended medication changes on hospital discharge. J Gen Intern Med. 2012;27(11):1513-20.
4. Kripalani S, Roumie CL, Dalal AK, Cawthon C, Businger A, Eden SK, et al. Effect of a pharmacist intervention on clinically important medication errors after hospital discharge: a randomized trial. Ann Intern Med. 2012;157(1):1-10.
5. Forster AJ, Murff HJ, Peterson JF, Gandhi TK, Bates DW. The incidence and severity of adverse events affecting patients after discharge from the hospital. Ann Intern Med. 2003;138(3):161-7.
6. Auerbach AD, Kripalani S, Vasilevskis EE, Sehgal N, Lindenauer PK, Metlay JP, et al. Preventability and Causes of Readmissions in a National Cohort of General Medicine Patients. JAMA Intern Med. 2016;176(4):484-93.