Discrepancies between in-home interviews and electronic medical records on regularly used drugs among home care clients.

PURPOSE

To compare discrepancies between in-home interviews and electronic medical records (EMRs) on regularly used prescription drugs among older home care clients.

METHODS

The participants were home care clients aged 75 years or older living in three Finnish municipalities. In-home interview data on regular prescription drug use from 276 home care clients were compared with EMRs. Agreement between the in-home interview data and EMRs was assessed using Cohen's kappa.

RESULTS

A majority (83%, n = 229) of the home care clients had discrepancies between in-home interview data and EMRs, and 40% had discrepancies that could clinically compromise their treatment. Living with a spouse or other family member, use of private health care services, diagnosed asthma/COPD or excessive polypharmacy was associated with having discrepancies. Discrepancies were more common among clients with better functioning and ability to self-manage drug use. Agreement between in-home interview data and EMRs was very good or good for other drug groups, but moderate for opioids, paracetamol, benzodiazepines and benzodiazepine-related drugs and lubricant eye drops, and poor for selective beta-2-adrenoceptor agonists. The most common clinically important discrepancies were psychotropics, opioids and agents acting on the renin-angiotensin system and beta-blocking agents.

CONCLUSIONS

Eight out of ten home care clients had discrepancies between in-home interview data and EMRs. Of these discrepancies, 40% were clinically important.