[Reporting the discharge medication in the discharge letter. An explorative survey of family doctors]

Abstract

Background and purpose: In Germany, the discharge medication is usually reported to the general practitioner (GP) by an inital short report (SR)/notification (handed over to the patient) and later by a more detailed discharge letter (DL) of the hospital. The quality and appropriateness of these reports have been occasionally objected. Until now, a systematic survey has not been reported.

Methods: N = 536 GPs (from Franfurt am Main and Luebeck) were asked after the typical report format of their patients discharge medication by the local hospitals. The questionnaire asked for 26 items covering (1) the designation of the medication (brand name, generic name) in SR and DL, (2) further specifications, e. g., possibilities of generic substitution or supervision of sensible medications, (3) reasons why GPs do not follow the hospitals recommendations, and (4) possibilities for an improvement in the medication-related communication between GP and hospitals.

Results: 39% GPs responded sufficiently to the questionnaire. The majority of the GPs (82%) quoted that in the SR only brand names are given (often or ever) and neither the generic name nor any further information on generic substitution is available (seldom or never). 65% of the responders quoted that even in the DL only brand names are given. Only 41% of the reponders quoted that further treatment-relevant specifications are given (often or ever). 95% responded that new medications or change of custom medication are seldom or never explained in the DL and GP were not explicitly informed about relevant medication changes. 58% of the responders quoted economic reasons for readjustment of the discharge medication, e.g., by generic substitution. The majority of responders (83%) are favoring (useful or very useful) a predischarge information (e. g., via fax) about the medication and 54% a hot line to some relevant person in the hospital should treatment problems emerge. 67% of the responders quoted in favor of regular meetings between GPs and hospital doctors regarding actual pharmacotherapy.

Conclusion: This survey points to marked deficiencies in reporting the discharge medication to GPs, which leave room for improvement.