Abstract: SA-PO616
Medication Reconciliation in Veterans Receiving Dialysis at Edward Hines VA Hospital: A Quality Improvement Initiative
Session Information
- Hemodialysis: Case Reports, Series, QI Projects
November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Cintrón-García, Juan J., Loyola University Health System, Maywood, Illinois, United States
- Guerrero, Roberto, Loyola University Health System, Maywood, Illinois, United States
- Kramer, Holly J., Loyola University Health System, Maywood, Illinois, United States
- Griffin, Karen A., Loyola University Health System, Maywood, Illinois, United States
- Vellanki, Kavitha, Loyola University Health System, Maywood, Illinois, United States
Background
Polypharmacy, commonly defined as use of 5 or more medications, is associated with higher morbidity, fall risk, functional decline and disability. We aimed to identify prevalence of medication discrepancy and possible risk factors in veterans receiving dialysis at Hines VA hospital.
Methods
Eligible patients were asked to bring all pill bottles at least once during the study period, October 2022 to March 2023. Medical records were then reviewed to identify discrepancies. Collected data included age, race, sex, cause of end stage renal disease (ESRD), dialysis vintage time, dialysis modality, no: of providers involved, no: of prescribed medications and presence of care giver at home. Cognitive screening was done using Montreal Cognitive Assessment Test (MoCA).
Results
A total 48 patients participated in the study. Baseline characteristics are shown in Table 1. 32 patients had at least one medication discrepancy. Compared to patients that completed MoCA (36/48), those that declined (12/48) had higher percentage of medication discrepancies (75% vs. 63%) despite having a caregiver (71% vs. 61%) (Image 1). 11 of the 12 patients declining MoCA were receiving hemodialysis (HD).
Conclusion
We found high prevalence of medication discrepancy in our veteran ESRD patients. MoCA scores were not associated with medication discrepancies, but those declining MoCA or with poor overall interest tended to have more discrepancies. Our study limitation is small sample size of a single center veteran population.
Baseline characteristics of study population
| Age in years | Average age: 68 |
| Race | 29-African American 17-White 2-Other race |
| Sex | 46-Male 2-Female |
| Cause of ESRD | 29-DM 6-HTN 3-GN 10-Other |
| Dialysis vintage time in years | Average 3.7 years |
| Modality of dialysis (HD vs. PD) | 41-HD 7-PD |
| No: of providers involved in care | Average: 3 |
| No: of prescribed medications | Average: 9 |
| Mean MoCA score (N = 36) | 20 (total score = 30) |
Image 1
Funding
- Veterans Affairs Support