Addressing prescription discrepancies in renal patients: A prospective audit

Abstract

Background Management of chronic renal failure requires complex medication regimens to manage hypertension, hyperlipidaemia, diabetes, phosphate, anaemia and acidosis. Patient engagement in medicine management is essential to avoid potential harm. Methods We prospectively audited the rate of discrepancies between our hospital record of patient medications and their current prescription. We investigated whether changes to appointment letters reduced the number of discrepancies. Results The proportion of patients attending renal outpatient clinics failing to bring a list or unable to recall their medications fell over a 3-year period following changes to appointment letters (median proportion: 0.45 in 2014, 0.36 in 2015, 0.30 in 2016, Chi-sq = 46.94, p < 0.001); percentage of patients forgetting to bring a list with significant prescription discrepancies fell from 10.9% in 2014 to 3.9% in 2016). Conclusion Changes to appointment letters can potentially improve prescribing safety in an outpatient setting.