Potentially Unintended Discontinuation of Long-term Medication Use After Elective Surgical Procedures | Cardiology | JAMA Internal Medicine | JAMA Network
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1.
Cook  RIRender  MWoods  DD Gaps in the continuity of care and progress on patient safety.  BMJ 2000;320791- 794PubMedGoogle ScholarCrossref
2.
Coleman  EABerenson  RA Lost in transition: challenges and opportunities for improving the quality of transitional care.  Ann Intern Med 2004;141533- 536PubMedGoogle ScholarCrossref
3.
Gottlieb  DJParenti  CMPeterson  CALofgren  RP Effect of a change in house staff work schedule on resource utilization and patient care.  Arch Intern Med 1991;1512065- 2070PubMedGoogle ScholarCrossref
4.
Lofgren  RPGottlieb  DWilliams  RARich  EC Post-call transfer of resident responsibility: its effect on patient care.  J Gen Intern Med 1990;5501- 505PubMedGoogle ScholarCrossref
5.
Laine  CGoldman  LSoukup  JRHayes  JG The impact of a regulation restricting medical house staff working hours on the quality of patient care.  JAMA 1993;269374- 378PubMedGoogle ScholarCrossref
6.
Petersen  LABrennan  TAO'Neil  ACCook  EFLee  TH Does housestaff discontinuity of care increase the risk for preventable adverse events?  Ann Intern Med 1994;121866- 872PubMedGoogle ScholarCrossref
7.
Moore  CWisnivesky  JWilliams  SMcGinn  T Medical errors related to discontinuity of care from an inpatient to an outpatient setting.  J Gen Intern Med 2003;18646- 651PubMedGoogle ScholarCrossref
8.
Hayward  RAAsch  SMHogan  MMHofer  TPKerr  EA Sins of omission: getting too little medical care may be the greatest threat to patient safety.  J Gen Intern Med 2005;20686- 691PubMedGoogle ScholarCrossref
9.
Tierney  WM Adverse outpatient drug events—a problem and an opportunity.  N Engl J Med 2003;3481587- 1589PubMedGoogle ScholarCrossref
10.
Gurwitz  JHField  TSHarrold  LR  et al.  Incidence and preventability of adverse drug events among older persons in the ambulatory setting.  JAMA 2003;2891107- 1116PubMedGoogle ScholarCrossref
11.
Forster  AJMurff  HJPeterson  JFGandhi  TKBates  DW The incidence and severity of adverse events affecting patients after discharge from the hospital.  Ann Intern Med 2003;138161- 167PubMedGoogle ScholarCrossref
12.
Moxey  EDO'Connor  JPNovielli  KDTeutsch  SNash  DB Prescription drug use in the elderly: a descriptive analysis.  Health Care Financ Rev 2003;24127- 141PubMedGoogle Scholar
13.
Kaufman  DWKelly  JPRosenberg  LAnderson  TEMitchell  AA Recent patterns of medication use in the ambulatory adult population of the United States: the Slone survey.  JAMA 2002;287337- 344PubMedGoogle ScholarCrossref
14.
Besdine  RBoult  CBrangman  S  et al.  Caring for older Americans: the future of geriatric medicine.  J Am Geriatr Soc 2005;53(6)(suppl)S245- S256PubMedGoogle Scholar
15.
Landefeld  CS Improving health care for older persons.  Ann Intern Med 2003;139421- 424PubMedGoogle ScholarCrossref
16.
Naylor  CDAnderson  GMGoel  V Patterns of health care in Ontario.  Toronto, Ontario Institute for Clinical Evaluative Sciences1994;
17.
Williams  JIYoung  W A summary of studies on the quality of health care administrative databases in Canada. Goel  VWilliams  JIAnderson  GMBlacksterin-Hirsch  PFooks  CNaylor  CD Patterns of Health Care in Ontario The ICES Practice Atlas. Ottawa, Ontario Canadian Medical Association1996;339- 345Google Scholar
18.
Gurwitz  JHGlynn  RJMonane  M  et al.  Treatment for glaucoma: adherence by the elderly.  Am J Public Health 1993;83711- 716PubMedGoogle ScholarCrossref
19.
Ganz  DAGlynn  RJMogun  HKnight  ELBohn  RLAvorn  J Adherence to guidelines for oral anticoagulation after venous thrombosis and pulmonary embolism.  J Gen Intern Med 2000;15776- 781PubMedGoogle ScholarCrossref
20.
Benner  JSGlynn  RJMogun  HNeumann  PJWeinstein  MCAvorn  J Long-term persistence in use of statin therapy in elderly patients.  JAMA 2002;288455- 461PubMedGoogle ScholarCrossref
21.
Avorn  JMonette  JLacour  A  et al.  Persistence of use of lipid-lowering medications: a cross-national study.  JAMA 1998;2791458- 1462PubMedGoogle ScholarCrossref
22.
Kass  MAGordon  MMorley  RE  JrMeltzer  DWGoldberg  JJ Compliance with topical timolol treatment.  Am J Ophthalmol 1987;103188- 193PubMedGoogle Scholar
23.
Jackevicius  CAMamdani  MTu  JV Adherence with statin therapy in elderly patients with and without acute coronary syndromes.  JAMA 2002;288462- 467PubMedGoogle ScholarCrossref
24.
Kass  MAGordon  MOHoff  MR  et al.  Topical timolol administration reduces the incidence of glaucomatous damage in ocular hypertensive individuals: a randomized, double-masked, long-term clinical trial.  Arch Ophthalmol 1989;1071590- 1598PubMedGoogle ScholarCrossref
25.
Epstein  DLKrug  JH  JrHertzmark  ERemis  LLEdelstein  DJ A long-term clinical trial of timolol therapy versus no treatment in the management of glaucoma suspects.  Ophthalmology 1989;961460- 1467PubMedGoogle ScholarCrossref
26.
Fodor  JGFrohlich  JJGenest  JJ  JrMcPherson  PR Recommendations for the management and treatment of dyslipidemia: report of the Working Group on Hypercholesterolemia and Other Dyslipidemias.  CMAJ 2000;1621441- 1447PubMedGoogle Scholar
27.
Hart  RGHalperin  JLPearce  LA  et al.  Lessons from the Stroke Prevention in Atrial Fibrillation trials.  Ann Intern Med 2003;138831- 838PubMedGoogle ScholarCrossref
28.
Bajcar  JFarrell  BFoisy  M Patient-centered transfer of medicine-related information: an evaluation of a model: part 1.  Can Pharm J 1997;13027- 30Google Scholar
29.
Bajcar  JKennie  NEinarson  T Collaborative medication management in a team-based primary care practice: an explanatory conceptual framework.  Res Soc Adm Pharm 2005;1408- 429PubMedGoogle ScholarCrossref
30.
Kearon  CHirsh  J Management of anticoagulation before and after elective surgery.  N Engl J Med 1997;3361506- 1511PubMedGoogle ScholarCrossref
31.
Dunn  ASTurpie  AG Perioperative management of patients receiving oral anticoagulants: a systematic review.  Arch Intern Med 2003;163901- 908PubMedGoogle ScholarCrossref
32.
Pass  SESimpson  RW Discontinuation and reinstitution of medications during the perioperative period.  Am J Health Syst Pharm 2004;61899- 912PubMedGoogle Scholar
33.
 Canadian Classification of Diagnostic, Therapeutic, and Surgical Procedures.  Ottawa, Ontario Statistics Canada1993;
34.
Steiner  JFProchazka  AV The assessment of refill compliance using pharmacy records: methods, validity, and applications.  J Clin Epidemiol 1997;50105- 116PubMedGoogle ScholarCrossref
35.
Schneeweiss  SMaclure  MSoumerai  SBWalker  AMGlynn  RJ Quasi-experimental longitudinal designs to evaluate drug benefit policy changes with low policy compliance.  J Clin Epidemiol 2002;55833- 841PubMedGoogle ScholarCrossref
36.
Schneeweiss  SSeeger  JDMaclure  MWang  PSAvorn  JGlynn  RJ Performance of comorbidity scores to control for confounding in epidemiologic studies using claims data.  Am J Epidemiol 2001;154854- 864PubMedGoogle ScholarCrossref
37.
Boockvar  KFishman  EKyriacou  CKMonias  AGavi  SCortes  T Adverse events due to discontinuations in drug use and dose changes in patients transferred between acute and long-term care facilities.  Arch Intern Med 2004;164545- 550PubMedGoogle ScholarCrossref
38.
Himmel  WTabache  MKochen  MM What happens to long-term medication when general practice patients are referred to hospital?  Eur J Clin Pharmacol 1996;50253- 257PubMedGoogle ScholarCrossref
39.
Eisen  GMBaron  THDominitz  JA  et al.  Guideline on the management of anticoagulation and antiplatelet therapy for endoscopic procedures.  Gastrointest Endosc 2002;55775- 779PubMedGoogle ScholarCrossref
40.
Dean  BSchachter  MVincent  CBarber  N Causes of prescribing errors in hospital inpatients: a prospective study.  Lancet 2002;3591373- 1378PubMedGoogle ScholarCrossref
41.
Whyte  JGreenan  E Pattern and quality of recording pre-admission drug treatment in paediatric patients.  BMJ 1976;161- 63PubMedGoogle ScholarCrossref
42.
Barnes  PKHoile  RW Emergency admissions to a general medical unit: a survey of the accompanying letters, with recommendations.  BMJ 1969;4424- 425PubMedGoogle ScholarCrossref
43.
Beveridge  TPetrie  JC Transfer of information about intake of drugs by patients referred to medical units.  BMJ 1972;237- 39PubMedGoogle ScholarCrossref
44.
Lau  HSFlorax  CPorsius  AJDe  BA The completeness of medication histories in hospital medical records of patients admitted to general internal medicine wards.  Br J Clin Pharmacol 2000;49597- 603PubMedGoogle ScholarCrossref
45.
Cochrane  RAMandal  ARLedger-Scott  MWalker  R Changes in drug treatment after discharge from hospital in geriatric patients.  BMJ 1992;305694- 696PubMedGoogle ScholarCrossref
46.
Cornish  PLKnowles  SRMarchesano  R  et al.  Unintended medication discrepancies at the time of hospital admission.  Arch Intern Med 2005;165424- 429PubMedGoogle ScholarCrossref
47.
Katz  ENicod  PBrunner  HRWaeber  B Changes in treatment during and after hospitalization in patients taking drugs for cardiovascular diseases.  Cardiovasc Drugs Ther 1996;10189- 192PubMedGoogle ScholarCrossref
48.
Beers  MHDang  JHasegawa  JTamai  IY Influence of hospitalization on drug therapy in the elderly.  J Am Geriatr Soc 1989;37679- 683PubMedGoogle Scholar
49.
Abrams  JAndrews  K The influence of hospital admission on long-term medication of elderly patients.  J R Coll Physicians Lond 1984;18225- 227PubMedGoogle Scholar
50.
Schumock  GTGuenette  AJKeys  TVHutchinson  RA Prescribing errors for patients about to be discharged from a university teaching hospital.  Am J Hosp Pharm 1994;512288- 2290PubMedGoogle Scholar
51.
Kellaway  GSMcCrae  E Non-compliance and errors of drug administration in patients discharged from acute medical wards.  N Z Med J 1975;81508- 512PubMedGoogle Scholar
52.
Sexton  JBrown  A Problems with medicines following hospital discharge: not always the patient's fault?  J Soc Adm Pharm 1999;18199- 207Google Scholar
53.
van Walraven  CSeth  RLaupacis  A Dissemination of discharge summaries: not reaching follow-up physicians.  Can Fam Physician 2002;48737- 742PubMedGoogle Scholar
54.
Bolton  PMira  MKennedy  PLahra  MM The quality of communication between hospitals and general practitioners: an assessment.  J Qual Clin Pract 1998;18241- 247PubMedGoogle ScholarCrossref
55.
van der Kam  WJMeyboom de Jong  BTromp  TFMoorman  PWvan der  LJ Effects of electronic communication between the GP and the pharmacist: the quality of medication data on admission and after discharge.  Fam Pract 2001;18605- 609PubMedGoogle ScholarCrossref
56.
 Getting started kit: prevent adverse drug events (medication reconciliation). Institute for Health Improvement. http://www.ihi.org/NR/rdonlyres/47D5AE1C-0B29-4A59-8D58-BABF8F4E829F/0/ADEHowtoGuideFINAL5_25.pdf. 2006. Accessed August 21, 2006
57.
Kaushal  RBarker  KNBates  DW How can information technology improve patient safety and reduce medication errors in children's health care?  Arch Pediatr Adolesc Med 2001;1551002- 1007PubMedGoogle ScholarCrossref
58.
Coleman  EAMahoney  EParry  C Assessing the quality of preparation for posthospital care from the patient's perspective: the care transitions measure.  Med Care 2005;43246- 255PubMedGoogle ScholarCrossref
59.
Thomas  EJPetersen  LA Measuring errors and adverse events in health care.  J Gen Intern Med 2003;1861- 67PubMedGoogle ScholarCrossref
60.
Marley  RASwanson  J Patient care after discharge from the ambulatory surgical center.  J Perianesth Nurs 2001;16399- 417PubMedGoogle ScholarCrossref
61.
Wheeler  KCrawford  RMcAdams  D  et al.  Inpatient to outpatient transfer of care in urban patients with diabetes: patterns and determinants of immediate postdischarge follow-up.  Arch Intern Med 2004;164447- 453PubMedGoogle ScholarCrossref
62.
Gandhi  TK Fumbled handoffs: one dropped ball after another.  Ann Intern Med 2005;142352- 358PubMedGoogle ScholarCrossref
63.
Branger  PJvan der Wouden  JCSchudel  BR  et al.  Electronic communication between providers of primary and secondary care.  BMJ 1992;3051068- 1070PubMedGoogle ScholarCrossref
64.
van Walraven  CLaupacis  ASeth  RWells  G Dictated versus database-generated discharge summaries: a randomized clinical trial.  CMAJ 1999;160319- 326PubMedGoogle Scholar
65.
Avorn  J Improving drug use in elderly patients: getting to the next level.  JAMA 2001;2862866- 2868PubMedGoogle ScholarCrossref
66.
Bell  CMRahimi-Darabad  POrner  AI Discontinuity of chronic medications in patients discharged from the intensive care unit.  J Gen Intern Med 2006;21937- 941PubMedGoogle ScholarCrossref
67.
Mamdani  MRochon  PAJuurlink  DN  et al.  Observational study of upper gastrointestinal haemorrhage in elderly patients given selective cyclo-oxygenase-2 inhibitors or conventional non-steroidal anti-inflammatory drugs.  BMJ 2002;325624PubMedGoogle ScholarCrossref
68.
Brook  RHAppel  FAAvery  COrman  MStevenson  RL Effectiveness of inpatient follow-up care.  N Engl J Med 1971;2851509- 1514PubMedGoogle ScholarCrossref
Original Investigation
December 11/25, 2006

Potentially Unintended Discontinuation of Long-term Medication Use After Elective Surgical Procedures

Author Affiliations

Author Affiliations: Departments of Medicine (Drs Bell and Bierman), Health Policy Management and Evaluation (Drs Bell, Bierman, and Urbach), Family and Community Medicine (Dr Bajcar), and Surgery (Dr Urbach), and Faculties of Pharmacy (Drs Bajcar and Mamdani) and Nursing (Dr Bierman), University of Toronto; Institute for Clinical Evaluative Sciences (Drs Bell, Bierman, Li, Mamdani, and Urbach); Department of Medicine, St Michael's Hospital (Drs Bell and Bierman); Cancer Care Ontario and Department of Surgery, University Health Network (Dr Urbach); Toronto, Ontario.

Arch Intern Med. 2006;166(22):2525-2531. doi:10.1001/archinte.166.22.2525
Abstract

Background  Transitions between health care settings represent vulnerable periods for medical error. Discontinuation of long-term medication use may occur during discharge from the hospital to the community.

Methods  We performed a population-based, cohort study using administrative records from Ontario, Canada, between April 1, 1997, and September 30, 2002. We studied all residents 66 years and older with continuous use of warfarin, 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins), or β-blocker ophthalmic drops for 1 or more years. Those who had an overnight hospitalization for selected elective surgical procedures were compared with 2 control groups: one that had an ambulatory procedure and one that had no procedures. All groups were assessed for the outcome of failure to renew the prescription within 6 months.

Results  Rates of drug treatment discontinuation after overnight hospitalizations, after ambulatory procedures, and after no procedures were 11.4%, 7.5%, and 4.8%, respectively, in the warfarin group; 4.0%, 3.9%, and 3.9%, respectively, in the statin group; and 8.4%, 8.9%, and 7.9%, respectively, in the ophthalmic drops group. The adjusted odds ratio (OR) was 2.6 (95% confidence interval [CI], 2.0-3.4) for discontinuation of warfarin therapy after overnight hospitalizations and 1.6 (95% CI, 1.4-1.7) after ambulatory procedures. In contrast, there was no increased risk of discontinuing treatment with either statins (OR for overnight hospitalization, 1.0 [95% CI, 0.9-1.2]; OR for ambulatory procedure, 1.0 [95% CI 1.0-1.1]) or ophthalmic drops (OR for overnight hospitalization, 1.0 [95% CI, 0.8-1.5]; OR for ambulatory procedure, 1.1 [95% CI, 1.0-1.2]).

Conclusions  Patients prescribed long-term therapy with warfarin were at risk for potentially unintended medication discontinuation after elective procedures. Patients prescribed statins or β-blocker ophthalmic drops were not at increased risk.

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