Hospital Patients Given Wrong Medicine On Discharge

Three out of four patients go home from the hospital with the wrong prescriptions or a lack of understanding about their medications.

That’s the disturbing conclusion of a new study from Yale-New Haven Hospital.

The chief researcher, Dr. Leora Horwitz, who also practices at the hospital, said health care providers “do a relatively poor job of educating patients about their medications.”

Medical malpractice mistakes involving medication errors cause injuries to more than 1.3 million persons a year.

This is from the New Haven Register:

A recent study [Dr. Horowitz] led looked at 377 patients at Yale-New Haven Hospital, ages 64 and older, who had been admitted with heart failure, acute coronary syndrome or pneumonia, then discharged to home.

Of that group, 307 patients – 81 percent – either experienced a provider error in their discharge medications or had no understanding of at least one intended medication change….

“We’re talking about the vast majority of our patients going home at potential risk” of medication problems, Horwitz said. “That’s huge. Collectively, something is not right.”

The Yale study relied on interviews with patients after discharge, who were asked about their medication regimen. The researchers also reviewed patients’ admission and discharge medication records to see if all changes were intentional, or if any appeared to be errors.

Other findings from the study:

• Twenty-four percent of the medication changes were due to provider error.
• The average patient had no understanding of 60 percent of all stopped, re-dosed and new medications.
• Errors and misunderstanding were more common for medications not related to the patient’s primary diagnosis than for those related to the main ailment being treated.
• The electronic medical records system used at Yale and other hospitals makes it hard to track and reconcile medication changes.
• Patient discharge lists don’t flag which prescriptions are new and which have been stopped.
• Patients at many hospitals get a quick drug rundown from a nurse before discharge, but not a thorough review that ensures they understand the medications.

In the article, Dr. Horowitz recounted a horror story that happened to one of her patients. The patient was switched to a new beta blocker for high blood pressure during an inpatient hospital stay. She landed back in the hospital after discharge when she took both the new medication and her old beta blocker – a combination that lowered her heart rate and blood pressure to dangerous levels.

Medical malpractice errors – including prescription mistakes – are responsible for up to 98,000 wrongful deaths in American hospitals each year.