東華大學圖書館 |

Post-Hospital Medication Reconciliation in Older Chinese-American Home Care Patients /

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Post-Hospital Medication Reconciliation in Older Chinese-American Home Care Patients // Sophia Huey-Lan Hu.
作者:	Hu, Sophia Huey-Lan,
面頁冊數:	1 electronic resource (184 pages)
附註:	Source: Dissertations Abstracts International, Volume: 74-04, Section: B.
Contained By:	Dissertations Abstracts International74-04B.
標題:	Gerontology. -
電子資源:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3525432
ISBN:	9781267573001

Post-Hospital Medication Reconciliation in Older Chinese-American Home Care Patients /
Hu, Sophia Huey-Lan,

Post-Hospital Medication Reconciliation in Older Chinese-American Home Care Patients /Sophia Huey-Lan Hu. - 1 electronic resource (184 pages)

Source: Dissertations Abstracts International, Volume: 74-04, Section: B.

Medication safety is a great concern for older adults with complex medication regimens, especially during the care transitions in the U.S. healthcare system. Medication reconciliation has been suggested as a critical process to avoid medication errors, including medication discrepancies (MDs) and the use of potential inappropriate medications (PIMs). Most studies only investigate one of these medication errors, which under-present the complexity of the medication management during care transitions. Older adults are at a high risk for medication-error-related negative consequences, including adverse drug events (ADEs), poor health outcomes, and an increase in healthcare utilization and expenses. One in every five older home care patients experienced at least one ADE within one month following hospital discharge. Older Chinese-Americans are especially at high risk for medication errors since the great majority are immigrants with low education levels and limited English proficiency. These barriers in communicating their health needs are compounded by their mistrust of Western medication. Despite their vulnerability, little is known about the prevalence and types of the common medication errors (e.g., PIMs and MDs), in older Chinese-Americans during transitions from hospital to home care. PIMs and MDs share similar contributing factors, including number or type of medications, prescriber, hospital unit, and patient characteristics in the continuum-of-care and thus, patients who experience one medication error may be more likely to experience another one. Informed by Human Error Theory and the Continuum of Care model, the purpose of this retrospective, nonexperimental, descriptive correlational study was to investigate the prevalence of PIMs and MDs as well as the relationship between them. The visiting nurse's responses to these two errors in older Chinese-American home care patients following hospital discharge in New York City were also explored. The 2002 Beers diagnosis-independent criteria was used to identify PIMs from hospital discharge medication order. To detect MDs, the electronic hospital discharge medication order was compared to the home care admission medication order. Cramer's V and Phi coefficient, Point and Rank biserial correlation coefficient, Spearman Rho correlation coefficient, one-way analysis of variance (ANOVA) and logistic regression were used to analyze data. Thirty-five percent of older Chinese-Americans who met the inclusion and exclusion criteria enrolled in the study (n=82). More than 80% of them had limited English capability and low education levels. About 24% of study participants had at least one PIM at hospital discharge. Nearly 67% of them had at least one MD at home care admission. Study participants who had PIM were more likely to experience MD (r=.217, p=.05). Older Chinese-Americans with more medications prescribed at hospital discharge were more likely to have at least one PIM (r=.444, p=.00) and have a higher number of PIM (r=.313, p=.004). With more medications prescribed at hospital discharge, they were more likely to have less MD (r=-.212, p=.018), but a positive association (r=.311, p=.005) was found between the number of medications documented at home care admission and MDs. Patient age and length of hospital stay was also positively associated with PIM (r=.29, p=.038 and r=.287, p=.01, respectively). Patients age 81 and older were almost 5 times (OR=4.59, 95% CI: 1.30-16.19) more likely than patients age 80 and younger to have PIMs at hospital discharge. Patients who took 8 medications and more at hospital discharge or had 6 days or longer hospital stay were about 4 times (OR=3.92, 95% CI: 1.08-14.22; OR=4.16, 95% CI: 1.09-15.88, respectively) more likely than patients who took less medication and shorter hospital stay to have PIMs at hospital discharge. Patients with 10 and higher medications identified at home care admission were almost 3 times (OR=2.57, 95% CI: 1.00-6.61) more likely than patients with less medications to have MDs. The study findings support the practice of checking for both the inconsistency as well as the appropriateness of the medication during the medication reconciliation process. Long-term use of stimulant laxatives, overuse of ferrous sulfate, amiodarone, and cyproheptadine were the four most common PIMs identified in this sample. Missing agent is the most common type of MDs identified. These findings indicate the high risk older Chinese-Americans had for PIMs and MDs during care transitions and the importance of reconciling medications during care transitions from hospital to home.

English

ISBN: 9781267573001Subjects--Topical Terms:

533633
Gerontology.
Subjects--Index Terms:

Chinese-Americans

Post-Hospital Medication Reconciliation in Older Chinese-American Home Care Patients /
LDR:06091nmm a22004453i 4500 001 2430683
005 20250605050126.5
006 m o d
007 cr|nu||||||||
008 261011s2012 miu||||||m |||||||eng d
020 $a 9781267573001
035 $a (MiAaPQD)AAI3525432
035 $a AAI3525432
040 $a MiAaPQD $b eng $c MiAaPQD $e rda
100 1 $a Hu, Sophia Huey-Lan, $e author. $3 3819126
245 1 0 $a Post-Hospital Medication Reconciliation in Older Chinese-American Home Care Patients / $c Sophia Huey-Lan Hu.
264 1 $a Ann Arbor : $b ProQuest Dissertations & Theses, $c 2012
300 $a 1 electronic resource (184 pages)
336 $a text $b txt $2 rdacontent
337 $a computer $b c $2 rdamedia
338 $a online resource $b cr $2 rdacarrier
500 $a Source: Dissertations Abstracts International, Volume: 74-04, Section: B.
500 $a Publisher info.: Dissertation/Thesis.
500 $a Advisors: Capezuti, Elizabeth.
502 $b Ph.D. $c New York University $d 2012.
520 $a Medication safety is a great concern for older adults with complex medication regimens, especially during the care transitions in the U.S. healthcare system. Medication reconciliation has been suggested as a critical process to avoid medication errors, including medication discrepancies (MDs) and the use of potential inappropriate medications (PIMs). Most studies only investigate one of these medication errors, which under-present the complexity of the medication management during care transitions. Older adults are at a high risk for medication-error-related negative consequences, including adverse drug events (ADEs), poor health outcomes, and an increase in healthcare utilization and expenses. One in every five older home care patients experienced at least one ADE within one month following hospital discharge. Older Chinese-Americans are especially at high risk for medication errors since the great majority are immigrants with low education levels and limited English proficiency. These barriers in communicating their health needs are compounded by their mistrust of Western medication. Despite their vulnerability, little is known about the prevalence and types of the common medication errors (e.g., PIMs and MDs), in older Chinese-Americans during transitions from hospital to home care. PIMs and MDs share similar contributing factors, including number or type of medications, prescriber, hospital unit, and patient characteristics in the continuum-of-care and thus, patients who experience one medication error may be more likely to experience another one. Informed by Human Error Theory and the Continuum of Care model, the purpose of this retrospective, nonexperimental, descriptive correlational study was to investigate the prevalence of PIMs and MDs as well as the relationship between them. The visiting nurse's responses to these two errors in older Chinese-American home care patients following hospital discharge in New York City were also explored. The 2002 Beers diagnosis-independent criteria was used to identify PIMs from hospital discharge medication order. To detect MDs, the electronic hospital discharge medication order was compared to the home care admission medication order. Cramer's V and Phi coefficient, Point and Rank biserial correlation coefficient, Spearman Rho correlation coefficient, one-way analysis of variance (ANOVA) and logistic regression were used to analyze data. Thirty-five percent of older Chinese-Americans who met the inclusion and exclusion criteria enrolled in the study (n=82). More than 80% of them had limited English capability and low education levels. About 24% of study participants had at least one PIM at hospital discharge. Nearly 67% of them had at least one MD at home care admission. Study participants who had PIM were more likely to experience MD (r=.217, p=.05). Older Chinese-Americans with more medications prescribed at hospital discharge were more likely to have at least one PIM (r=.444, p=.00) and have a higher number of PIM (r=.313, p=.004). With more medications prescribed at hospital discharge, they were more likely to have less MD (r=-.212, p=.018), but a positive association (r=.311, p=.005) was found between the number of medications documented at home care admission and MDs. Patient age and length of hospital stay was also positively associated with PIM (r=.29, p=.038 and r=.287, p=.01, respectively). Patients age 81 and older were almost 5 times (OR=4.59, 95% CI: 1.30-16.19) more likely than patients age 80 and younger to have PIMs at hospital discharge. Patients who took 8 medications and more at hospital discharge or had 6 days or longer hospital stay were about 4 times (OR=3.92, 95% CI: 1.08-14.22; OR=4.16, 95% CI: 1.09-15.88, respectively) more likely than patients who took less medication and shorter hospital stay to have PIMs at hospital discharge. Patients with 10 and higher medications identified at home care admission were almost 3 times (OR=2.57, 95% CI: 1.00-6.61) more likely than patients with less medications to have MDs. The study findings support the practice of checking for both the inconsistency as well as the appropriateness of the medication during the medication reconciliation process. Long-term use of stimulant laxatives, overuse of ferrous sulfate, amiodarone, and cyproheptadine were the four most common PIMs identified in this sample. Missing agent is the most common type of MDs identified. These findings indicate the high risk older Chinese-Americans had for PIMs and MDs during care transitions and the importance of reconciling medications during care transitions from hospital to home.
546 $a English
590 $a School code: 0146
650 4 $a Gerontology. $3 533633
650 4 $a Nursing. $3 528444
650 4 $a Health care management. $3 2122906
650 4 $a Older people. $3 761975
650 4 $a Home health care. $3 3692106
650 4 $a Hospitals. $3 616081
650 4 $a Asian Americans. $3 581214
650 4 $a Medicine. $3 641104
653 $a Chinese-Americans
653 $a Home health care
653 $a Medication errors
653 $a Post-hospital care
690 $a 0351
690 $a 0569
690 $a 0769
690 $a 0564
710 2 $a New York University. $e degree granting institution. $3 3765946
720 1 $a Capezuti, Elizabeth $e degree supervisor.
773 0 $t Dissertations Abstracts International $g 74-04B.
790 $a 0146
791 $a Ph.D.
792 $a 2012
856 4 0 $u https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3525432