Predictors of discrepancies between electronic medical records medication list and dispensing data in elderly inpatients with dementia

Background: Inaccuracies in pre-admission medication list are common and have been associated with adverse outcomes. Patients with dementia are frequently in polypharmacy and hospitalized. Discrepancies between hospital records and multiple integrated sources (e.g. community pharmacy, GPs letters, and patient owned medications) have been associated with increasing number of medications and emergency admission. Objectives: To assess predictors of discrepancies between hospital Electronic Medical Records (EMR) pre-admission medication list and prescription data in inpatients with dementia. Methods: Source of information: Hospital Services and Outpatient prescription Databases, hospital EMRs; Study design: retrospective cohort; Study population: all patients hospitalized at the Udine University Hospital, Italy, from 01.01.2012 to 31.12.2014 with primary or secondary ICD-9-CM discharge code for dementia and continuous enrolment for ≥1 year before admission; Data collection: for each hospitalization (a) the EMR pre-admission medication list; (b) all prescriptions dispensed within 3 months prior to the date of admission through record linkage with prescription database. An omission was defined as any dispensed medication not registered in EMR; an addition as any medication not dispensed registered in EMR. Statistical analysis: conditional logistic regression odds ratio (OR), with 95% confidence interval (95% CI), of ≥1 omission or ≥1 addition through generalized estimating equations to account for repeated hospitalizations of the same patient. Final model adjusted for type of admission (planned and emergency), patient age and sex, number of pre-admission prescriptions, and neuropsychiatric disturbances. Analysis performed with SAS© software, version 9.3 (SAS, Cary, NC, USA). The protocol was approved by the FVG regional Ethics Committee.