Grant: Travel Awards - Institute Community Support

Background: When patients are admitted to the hospital, it is common for many different changes to be made to their medications. Patients can have medications that they're taking prior to admission to hospital discontinued, the daily dose of a medication can be decreased or increased or patients can have new medications added in hospital. Even though patients are supposed to go to the pharmacy and fill their medications as per the instructions given on their discharge prescription once they leaving the hospital, how often patients actually do this has not been assessed. Therefore, the aim of this study was to further explore this issue. Population Studied: Patients who were admitted to two hospitals in Montreal, Quebec between 1 October 2014 and 31 May 2016 were included in our study. Results: 872 patients were included in our study, 37% were females and the average age for patients was 72 years. We found that when patients were hospitalized, around 9 changes were made to each patients medication regimens. The majority of these changes were new medications, followed by medications where the daily dose had been changed in hospital and new medications that were added in hospital. Overall, 20% of these changes were not followed by patients once they left the hospital; of these failures, 29% were medications where the daily dose was changed during hospitalization, but when patients went to fill their medications they did not fill them at the prescribed daily dose, 8% of new medications added in hospital were not filled at all when they left the hospital and 8% of medications that were discontinued in hospital were still filled at the pharmacy once the patient left the hospital. Implications: We found that it was common for patients not to follow all the changes that were made to their medications during hospitalization once discharged. Therefore, we suggest that programs should be created which will help improve this issue within the healthcare system