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Abstract
Introduction and objectives Cystic fibrosis (CF) is a multi-system disease requiring complex, high-burden treatment regimens. Discrepancies can arise between hospital and GP drug lists, in turn impacting patient’s access to required long-term medications. One large adult CF centre has been conducting medicines reconciliation at the point of transition from paediatric care, with the goal of identifying and eliminating such discrepancies.
The objective of this study was to evaluate the accuracy of hospital medication lists versus the GP repeat prescription lists, at the point of transition from paediatric to adult care.
Methods Drug lists were assessed for discrepancies, in drug or dose, as well as non-collection of items. These issues were sub-grouped to evaluate whether frequency varied by drug class.
Results Drug list from 99 patients from a 4.5-year period (2011–2016) were included, featuring a total of 1201 items, with a mean of 12, range 1–22, items per patient. There was a drug discrepancy in 11.7% of total items, with greatest frequency occurring in inhaled and nebulised antibiotics (20.0%), as seen in Figure 1. There was a dose discrepancy in 3.9% of total items, with greatest frequency occurring in oral antibiotics (8.7%). It was also found that 9.2% of items had not been collected from GP for ≥6 months, with greatest frequency occurring in nebulised medicines 13.8%.
Conclusions Discrepancies are common across CF medication lists. These may have a detrimental impact on clinical care, as patients are unable to access the required medicines from their GP, and hospitals may prematurely escalate care. Furthermore, a number of items prescribed by GPs are not regularly collected, indicating poor adherence. Medicines reconciliation at transition of care has a significant impact in identifying these issues, and CF centres should consider whether to also routinely include this process during CF annual reviews.
Drug discrepancy breakdown by class