Medication lists for elderly patients: clinic-derived versus in-home inspection and interview

Abstract

Objective: To determine how often the lists of regular medications derived in geriatric clinics by examination of "medication bags" and interview matched those found during in-home inspections and interviews.

Design: Prospective cross-sectional study.

Setting: Geriatric clinics at three university-affiliated hospitals.

Participants: Consecutive community-dwelling outpatients 65 years or older who were newly referred.

Methods: The in-home medication inspection used a semistructured interview followed by a room-to-room search. The medications identified in the home were compared with the medication list derived in clinic by examination of the "medication bag" and interview.

Main results: Fifty patients with a mean age of 78.9 years participated. The mean number of regular medications (prescription and nonprescription) was 6.3, and the mean number of regular prescription medications was 3.6. A comparison of clinic versus in-home medication lists revealed that 48% (95% confidence interval [95% CI], 34% to 62%) of patients had at least 1 omission of any regular medication and 19% (95%, CI 10% to 32%) of patients had at least 1 omission of a regular prescription medication.

Conclusion: The clinic-derived medication list resulted in a complete listing of all regular medications in only 52% taking regular medications. More specific instructions to patients to bring all prescription and nonprescription medications and all vitamins, herbal, and natural remedies, and more directed questions by physicians may result in more complete clinic medication lists.