Patient Care

Lower Health Literacy Contributes to Post-Discharge Medication Errors


Clinical question: What patient characteristics contribute to post-discharge medication errors?

Background: Post-discharge medication errors are common, but the characteristics of patients associated with those errors are not well understood.

Study design: Prospective study with patient data collected via baseline interview while hospitalized and then follow-up telephone calls at three, 30, and 90 days post discharge.

Setting: Vanderbilt Hospital, Nashville, Tenn.

Synopsis: Baseline information (race, ethnicity, education, marital status, income, social support, functional health literacy, cognition, self-rated health status, depression, preadmission medication adherence, and numeracy) was collected on adult hospitalized patients with acute coronary syndrome or acute decompensated heart failure. Post-discharge telephone interviews collected data on what medications (prescription and over the counter) patients were actually taking. Binomial logistic regression was used to determine patient characteristics that predicted discordance between the discharge medication list and the patient-reported list during the post-discharge medication review.

Of the 471 patients in the study (with a mean age of 59 years and mean total number of medications of 12), over half (51.4%) of patients were taking one or more discordant medications; 27.4% did not report a medication that was on their discharge list (omission); and 35.7% reported a medication that was not on their discharge list (commission). Further, over half (59.2%) of patients misunderstood an indication (i.e., clopidogrel is “for my stomach”), a dose, or a frequency.

Bottom line: Post-discharge medication errors are common. Lower health numeracy (the ability to use and understand numbers in daily life) and lower health literacy contributes to post-discharge medication errors.

Citation: Mixon AS, Myers AP, Leak CL, et al. Characteristics associated with postdischarge medication errors. Mayo Clin Proc. 2014;89(8):1042-1051.

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