You are here

  • Home
  • Archive
  • Volume 12, Issue 11
  • Medication management for patients with hip fracture at a regional hospital and associated primary care units in Norway: a descriptive study based on a survey of clinicians’ experience and a review of patient records

Article Text

Article menu
Health services research
Original research
Medication management for patients with hip fracture at a regional hospital and associated primary care units in Norway: a descriptive study based on a survey of clinicians’ experience and a review of patient records
  1. Ben Tore Henriksen1,2,3,
  2. Maria Krogseth4,5,6,
  3. Caroline Thy Nguyen1,7,
  4. Liv Mathiesen3,
  5. Maren Nordsveen Davies1,
  6. Randi Dovland Andersen8,9,
  7. Yvonne Andersson10
  1. 1Tonsberg Hospital Pharmacy, Hospital Pharmacies Enterprise, South Eastern Norway, Tonsberg, Norway
  2. 2Division of Surgery, Vestfold Hospital Trust, Tonsberg, Norway
  3. 3Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
  4. 4Old Age Psychiatry Research Network, Telemark Vestfold, Vestfold Hospital Trust, Tonsberg, Norway
  5. 5Department of Nursing and Health Science, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
  6. 6Department of Internal Medicine, Telemark Hospital Trust, Skien, Norway
  7. 7Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromso, Norway
  8. 8Department of Research, Telemark Hospital Trust, Skien, Norway
  9. 9Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
  10. 10Department of Research, Hospital Pharmacies Enterprise, South Eastern Norway, Oslo, Norway
  1. Correspondence to Ben Tore Henriksen; ben.tore.henriksen{at}sykehusapotekene.no

Abstract

Objective Patients with hip fracture are at high risk of medication errors due to a combination of high age, comorbidities, polypharmacy and several care transitions after fracture. The aim was to study medication management tasks concerning patient safety: medication reconciliation, medication review and communication of key medication information in care transitions.

Design Descriptive study comprising a self-administered clinician survey (MedHipPro-Q) and a retrospective review of hospital medical records of patients with hip fracture.

Setting Regional hospital and the associated primary care units (South-Eastern Norway).

Participants The survey received responses from 253 clinicians, 61 medical doctors and 192 nurses, involved in the medication management of patients with hip fracture, from acute admittance to the regional hospital, through an in-hospital fast track, primary care rehabilitation and back to permanent residence. Respondents’ representativeness was unknown, introducing a risk of selection and non-response bias, and extrapolating findings should be done with caution. The patient records review included a random sample of records of patients with hip fracture (n=50).

Outcome measures Medication reconciliation, medication review and communication of medication information from two perspectives: the clinicians’ (ie, experiences with medication management) and the practice (ie, documentation of completed medication management).

Results In the survey, most clinicians stated they performed medication reconciliation (79%) and experienced that patients often arrived without a medication list after care transition (37%). Doctors agreed that more patients would benefit from medication reviews (86%). In the hospital patient records, completed medication reconciliation was documented in most patients (76%). Medication review was documented in 2 of 50 patients (4%). Discharge summary guidelines were followed fully for 3 of 50 patients (6%).

Conclusion Our study revealed a need for improved medication management for patients with hip fracture. Patients were at risk of medication information not being transferred correctly between care settings, and medication reviews seemed to be underused in clinical practice.

  • Health & safety
  • Quality in health care

Data availability statement

No data are available.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2022-064868

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    No data are available.

    View Full Text

    Supplementary materials

    • Supplementary Data

      This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

    Footnotes

    • Contributors Conceptualisation—BTH, MK, LM, MND and YA. Project protocol—BTH, MK, MND and YA. Data collection/clinician survey—BTH. Data collection/patient records review—CTN. Data analysis and interpretation—BTH, MK, LM, RDA and YA. Writing the manuscript—BTH. Review and editing—BTH, MK, CTN, LM, MND, RDA and YA. BTH is responsible for the overall content as guarantor. All authors have approved the final version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.