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Med rec errors rampant at admission

April 2010

Published in the April 2010 issue of Today’s Hospitalist

Med rec errors rampant at admission

RESEARCHERS USING a pharmacist-led medication reconciliation process found that one out of three patients (35.9%) had a medication error at hospital admission, 85% of which originated in their medication histories. Almost half of those errors, researchers found, were medication omissions.

The study compared medication histories taken by pharmacists and inpatient physicians to medication orders. Not surprisingly, the study found that patients who take more medications and elderly patients were most at risk. The study was posted online in February by the Journal of General Internal Medicine.

Patients who presented pill bottles or their own medication list on admission had the lowest risk of reconciliation errors. The authors concluded that primary care physicians should be enlisted to ensure that patients have complete and accurate medication lists. The researchers, many of whom are from Northwestern Memorial Hospital in Chicago, posted the hospital’s medication reconciliation toolkit online.

Mortality soars in months after hip fracture

IN THE FIRST THREE MONTHS after suffering a hip fracture, older adults have a five- to eight-fold increased risk of death from all causes. A study in the March 16 Annals of Internal Medicine found that while mortality risk subsides after that initial three-month period, it never returns to levels seen in patients who have not experienced a hip fracture. Researchers also noted that the ongoing risk of mortality is higher for men. While the fact that hip fracture increases risk of mortality is “well-established,” researchers said that how that excess mortality plays out over time has not been clear.

The study also quantified the excess mortality at different time markers for patients who experienced hip fracture relative to those who did not. For white women at age 80 who’d had a hip fracture, their mortality risk at one, two, five and 10 years post-injury was 8%, 11%, 18% and 22% higher, respectively, than for white women of the same age who did not have a hip fracture.

The excess mortality rates for men at those time markers were even higher compared to men of the same age without hip fracture: 18%, 22%, 26% and 20%.

Data paint portrait of heart disease patients

NEW DATA FROM THE CDC show that the highest hospitalization rates for heart disease occur among blacks, and in counties located primarily in Appalachia, the Mississippi Delta, Texas and Oklahoma.

The report is the first time that statistics have been available on heart disease hospitalizations by county. According to the report, a significant number of Medicare beneficiaries live in areas where hospitals don’t offer specialized cardiac treatment facilities. In addition, 63% of counties lack a cardiologist except for those within the Veterans Affairs system, and 31% of counties do not have a hospital with an ED.

States that have the highest heart disease hospitalization rates generally have a two-fold increase in the number of patients hospitalized with heart disease over those with the lowest rates. Data were drawn from Medicare records between 2000 and 2006.