Background: Central nervous system medication (CNS med) use among older adults is associated with high morbidity and mortality. This study described patterns of CNS medication use, and identified people most likely to have CNS medications initiated or deprescribed around hospitalization. Methods: Retrospective cohort study using electronic health record data from 3-hospitals. Patients aged 65 years […]

Background: Duplicate as-needed (referred to hereafter as “PRN”) orders for common indications such as pain, nausea, insomnia, and constipation are frequent in hospitalized patients. Without explicit instructions for circumstances or order of administration, therapeutic duplication can cause confusion for nurses and violates both Join Commission and the Centers for Medicare & Medicaid Services (CMS) guidelines. […]

Background: Diabetes is an exceedingly common disease encountered by medical trainees, with over 8 million hospitalizations in 2018 listing type 1 or type 2 diabetes as a diagnosis (1). Evidence supports continuing certain oral diabetes medications during admission when safe, reflected in recent consensus statements from professional societies (2,3). Nevertheless, oral medications are often held […]

Background: Medication errors and adverse drug events are common in the pediatric population. Parents with limited English proficiency have increased risk of management errors and nearly a third of low-income families failed to pick up their child’s prescriptions after hospital discharge, with non-adherence rates as high as 40%. The objective of this study is to […]

Case Presentation: We present an 80-year-old female with a medical history significant for atrial fibrillation and heart failure with preserved ejection fraction. She underwent pulmonary vein isolation in 2017 and had reportedly been on flecainide 150 mg twice daily and atenolol 100 milligram twice daily since then. She presented to the emergency department with dyspnea […]

Background: Communication related to medications is an important metric on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to measure patient experience after discharge from the hospital. There are many factors which can lead to poor communication about medications (Figure 1). Over 20% of readmissions can be related to medications, and of […]

Background: Up to 45% of Americans do not fill prescriptions because of cost. Medication non-adherence annually leads to $100-$300B in excess morbidity and mortality. To better inform medication cost effects on a potentially vulnerable patient population, our primary aim was to measure annual patient out-of-pocket outpatient medication cost for patients without prescription drug insurance coverage […]