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Title: A study to evaluate the quality of medication-related information in the discharge summary of elderly patients discahrged from an acute hospital
Author: Purser, Kevin Anthony
ISNI:       0000 0004 7660 2008
Awarding Body: King's College London
Current Institution: King's College London (University of London)
Date of Award: 2019
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It has been found that patients are often readmitted to hospital due to medication-related incidents. The quality of medication-related information in the discharge summary may be a contributory factor leading to readmission. This study evaluated the quality of medication-related information in a discharge summary of elderly patients discharged from an acute hospital in relation to locally determined standards. The study was carried out in three phases: Phase I involved determining a local consensus for the essential or gold standards and desirable standards for medication-related information on a discharge summary using a modified e-Delphi technique. Phase II was carried out to measure the level of adherence to the standards determined by a retrospective, observational study of elderly patients of 65 years of age or older discharged from an acute hospital. Phase III involved a local expert panel assessing whether any subsequent readmissions within 30 days were due to the quality of discharge information. The results of the modified e-Delphi study using an expert panel had a response rate of 55.2% after round one and 34.4% after round two and provided the local standards. 155 patients' discharge summaries were then evaluated. An overall adherence score of 64.6% was found in relation to the gold standards. A level of adherence of 51.1% with medication changed with a reason stated on the discharge summary; 75.4% for medication stopped with a reason stated on the discharge summary and 84.8% for medication started with a reason stated on the discharge summary was found. There was some evidence that GPs do not always act upon the information in the discharge summary. In Phase III it was found that six patients were readmitted to hospital within 30 days due to medication with only two (1.3%) influenced by the quality of medication-related information. The study discusses the implications for clinical practice in preparation of a gold standard discharge summary including the need to design electronic discharge templates to include the gold standards and recommendations for training of junior doctors. An assessment tool to prioritise high risk patients to produce high quality discharge summary medication-information is proposed.
Supervisor: Davies, John Graham ; Auyeung, Wai Yee Vivian Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available