Continuity of long-term medication use after surgical hospital stay

Abstract

To investigate changes in long-term medication during the transfer between surgical hospital and primary care. To examine differences in defined daily doses (DDDs) versus real prescribed daily doses (PDDs). During a 15-month period, patients from three surgical wards in a university-based teaching hospital were asked about their medication at admission (T1), at discharge (T2), and 3 months after discharge (T3). Complete data were obtained for 299 patients (169 women, 130 men; mean age 69.5 years). Both DDD and PDD were calculated for each drug. Analysis of data was performed using a relational database. Patients took 3.6 drugs (+/-2.2) at T1, 5 (+/-2.4) at T2, and 3.8 (+/-3.1) at T3. After surgical intervention, a discontinuation of analgesic, anti-rheumatic, and thyroid medication was observed frequently (35% of discontinued drugs at T2). We found more drug alterations at T3 than at T2 (263 versus 87). Family doctors mostly changed medications prescribed for the cardiovascular system (22% of all cardiovascular agents were discontinued and/or started at T3). We could not determine those changes to be methodical. The total of PDDs and DDDs did not differ, but the mean PDDs of statins and beta-blocking agents were significantly below the DDDs (P<0.005). The observed changes in medication after hospitalization can be only partially attributed to a successful surgical intervention and to the hospital stay. Those alterations seemed not to be initiated by the intention of saving costs.