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Table 5 Completeness of medication-related information in discharge letter and community pharmacy and general practitioner medication overviews

From: Transition of care in stroke patients discharged home: a single-center prospective cohort study

 

Discharge letter overviews (n = 33)

Community pharmacy overviews (n = 33)

General practitioner overviews (n = 31)

Complete

documentation

n=, (%)a

Incomplete

documentation

n=, (%)a

No documentation

n=, (%)a

Complete

documentation

n=, (%)a

Incomplete

documentation

n=, (%)a

No documentation

n=, (%)a

Complete

documentation

n=, (%)a

Incomplete

documentation

n=, (%)a

No documentation

n=, (%)a

Unknown

n=, (%)a

Total prescriptions, n = 243

150

(62%)

60

(25%)

33

(14%)

144

(59%)

56

(23%)

43

(18%)

95

(39%)

58

(24%)

63

(26%)

27

(11%)

 Unchanged, n = 126

82

(65%)

23

(18%)

21

(17%)

92

(73%)

21

(17%)

13

(10%)

63

(50%)

24

(19%)

23

(18%)

16

(13%)

 Started, n = 67

52

(78%)

13

(19%)

2

(3%)

43

(64%)

4

(6%)

20

(30%)

28

(42%)

7

(10%)

29

(43%)

3

(4%)

 Change, n = 6

1

(17%)

4

(67%)

1

(17%)

2

(33%)

2

(33%)

2

(33%)

0

 

1

(17%)

2

(33%)

3

(50%)

 Switched, n = 20

8

(40%)

12

(60%)

0

 

7

(35%)

12

(60%)

1

(5%)

2

(10%)

11

(55%)

4

(20%)

3

(15%)

 Stopped, n = 24

7

(29%)

8

(33%)

9

(38%)

0

 

17

(71%)

7

(29%)

2

(8%)

15

(63%)

5

(21%)

2

(8%)

Clinically relevant prescriptions, n = 121

86

(71%)

29

(24%)

6

(5%)

72

(60%)

23

(19%)

26

(21%)

53

(44%)

25

(21%)

34

(28%)

9

(7%)

 Platelet aggregation inhibitors, n = 42

33

(79%)

8

(19%)

1

(2%)

27

(64%)

5

(12%)

10

(24%)

16

(38%)

6

(14%)

17

(40%)

3

(7%)

 Oral anticoagulants, n = 5

4

(80%)

0

 

1

(20%)

3

(60%)

0

 

2

(40%)

3

(60%)

2

(40%)

0

 

0

 

 Antihypertensive drugs, n = 35

26

(74%)

6

(17%)

3

(9%)

27

(77%)

4

(11%)

4

(11%)

26

(74%)

3

(9%)

4

(11%)

2

(6%)

 Statins, n = 32

21

(66%)

10

(31%)

1

(3%)

10

(31%)

12

(38%)

10

(31%)

6

(19%)

13

(41%)

10

(31%)

3

(9%)

 Ezetimibe, n = 1

1

(100%)

0

 

0

 

1

(100%)

0

 

0

 

1

(100%)

0

 

0

 

0

 

 Proton pump inhibitorsb, n = 6

1

(17%)

5

(83%)

0

 

4

(67%)

2

(33%)

0

 

1

(17%)

1

(17%)

3

(50%)

1

(17%)

  1. aPercentages are calculated relative to in-hospital overviews after medication reconciliation, which is considered the gold standard
  2. bOnly esomeprazole and omeprazole were assessed due to their interaction with clopidogrel