January/February 2020 Home Healthcare Now 31
Amanda S. Mixon, MD, MS, MSPH, FHM, Heidi Poppendeck, MPH, Sunil Kripalani, MD, MSc, Theodore Speroff,
PhD, MS, John Schnelle, PhD, Robert Dittus, MD, MPH, and Christianne Roumie, MD, MPH
In a prospective cohort study of Veterans and community
health nurses, we enrolled hospitalized older Veterans
referred to home care for skilled nursing and/or physical
or occupational therapy for posthospitalization care. We
assessed preadmission activities of daily living and instru-
mental activities of daily living, health literacy, numeracy,
and cognition. Postdischarge phone calls identified medi-
cation errors and medication reconciliation efforts by home
healthcare clinicians. Veterans Administration-based com-
munity health nurses completed surveys about content and
timing of postdischarge interactions with home healthcare
clinicians. We determined the types and frequency of
medication errors among older Veterans receiving home
healthcare, patient–provider communication patterns in
DISCREPANCIES
in Older Veterans Receiving Home Healthcare
MEDICATION
this setting, and patient characteristics affecting medica-
tion error rates. Most Veterans (24/30, 80%) had at least
one discordant medication, and only one noted that er-
rors were identified and resolved. Veterans were asked
about medications in the home healthcare setting, but far
fewer were questioned about medication-taking details,
adherence, and as-needed or nonoral medications. Higher
numeracy was associated with fewer errors. Veterans Ad-
ministration community health nurses reported contact by
home healthcare clinicians in 41% of cases (7/17). Given
the high rate of medication errors discovered, future work
should focus on implementing best practices for medica-
tion review in this setting, as well as documenting barriers/
facilitators of patient–provider communication.
ASSOCIATED PRESS
January/February 2020 Home Healthcare Now 31
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