Medication Discrepancies: We Can Do Better

Abstract Background Older people face risks of multi-morbidity and polypharmacy, leading to inappropriate prescribing, adverse reactions, and medication errors, which can pose injury risks and medico-legal issues. The WHO recognises drug safety as a global issue, and transitions of care increases the risk of medication errors due to potential communication challenges and various patient-related factors. Respite services are vital for frail older adults, allowing them to stay at home longer and providing a break for their informal carers. We have observed some prescription variances among respite service users in an HSE facility during their admissions over time. Methods The study aimed to compare the prescriptions provided by general practitioners before respite admission and the actual medications taken by service users. A retrospective review of 20 charts from June 2023 to January 2024 was conducted, comparing prescriptions received before admission and the medication list from the Kardex, which was checked against the actual medications the respite service users brought on admission day. Results Medication discrepancies were observed in 12 (60%) out of 20 charts. The types of inconsistencies identified as follows: Healthcare professionals may face prescription discrepancies related to inadequate information exchange, such as having multiple prescribers, patients failing to disclose alterations in their medications, changes made without consulting their physicians, older patients experiencing communication difficulties due to sensory impairment or dementia, and non-adherence to prescribed treatment regimens. Many of these prescription irregularities can be identified through medication reconciliation, an essential and reliable method for ensuring patient safety. Conclusion Inconsistencies in medication among older adults using respite services are prevalent, exacerbated by communication failures, multi-morbidity, and polypharmacy. This review suggests a multidisciplinary collaboration to reduce medication inconsistencies.