Improving the Management of Patients’ Own Medications in Hospitalized Older Adults: A Multidisciplinary Before-And-After Intervention Study

Xiaoyan Chen,1 Lin Liu,1 Jie Zhang,1 Linghua Zheng,1 Xiaona Chen,2 Mingxia Zhang31Department of Rehabilitation Medicine, Hangzhou Wuyunshan Hospital (Hangzhou Institute of Health Promotion), Hangzhou, 310008, People’s Republic of China; 2Department of Geriatrics, Hangzhou Wuyunshan Hospital (Hangzhou Institute of Health Promotion), Hangzhou, 310008, People’s Republic of China; 3Department of Pharmacy, Hangzhou Wuyunshan Hospital (Hangzhou Institute of Health Promotion), Hangzhou, 310008, People’s Republic of ChinaCorrespondence: Xiaoyan Chen, Email [email protected]: Patients’ own medications (POMs) may pose safety risks when their use is not integrated into hospital medication-management processes. This study evaluated a multidisciplinary intervention for POM management in hospitalized older adults.Patients and Methods: This single-center before-and-after intervention study was conducted from March 2024 to February 2025. The intervention comprised five coordinated components: physician-led assessment, authorization, order entry, guidance, and monitoring; pharmacist-led verification, order review, and record maintenance; nurse-led verification, supervision, and education using color-coded labels (green, approved for use; red, not to be used; yellow, awaiting confirmation); IT-led integration of POM information into the electronic medication administration record; and procurement-led upgrades to storage equipment. The primary outcome was the incidence rate of POM-related medication errors per 1000 patient-days. Secondary outcomes were correct POM documentation within 24 hours of admission and correct POM storage at the pre-discharge assessment.Results: The study included 162 patients, with 81 in each period. Before the intervention, 174 POM-related medication errors occurred over 1628 patient-days (106.9 per 1000 patient-days), compared with 29 errors over 1581 patient-days after the intervention (18.3 per 1000 patient-days). The incidence rate ratio was 0.172 (95% CI, 0.116– 0.254; P< 0.001), representing an 82.8% reduction. Correct POM documentation within 24 hours increased from 53.1% (43/81) to 92.6% (75/81; χ2=31.951, P< 0.001; OR=11.047, 95% CI, 4.319– 28.253; RR=1.744, 95% CI, 1.408– 2.160). Correct POM storage at the pre-discharge assessment increased from 32.1% (26/81) to 84.0% (68/81; χ2=44.707, P< 0.001).Conclusion: The intervention was associated with improvements in all three measured POM outcomes at this center. Multicenter studies with longer follow-up are needed to assess generalizability and sustainability.Keywords: older adults, self-administered medication, medication management, patient safety, multidisciplinary collaboration