Compliance with guidelines for continuity of care in therapeutics from hospital to community

Objectives: io evaluate compliance with the Australian Pharmaceutical Advis ory Council's National guidelines to achieve the continuum of quality use o f medicines between hospital and community. Design: Descriptive survey, based on questionnaires filled out by general p ractitioners, of a sample of patients following recent discharge from publi c hospitals, collated with hospital record reviews for a 20% subsample of t he patients. Participants and setting: 357 GPs practising within the postcode boundaries of the South East Sydney Area Health Service were randomly selected to tak e part in the survey. Of 219 GPs who agreed to participate, 106 completed q uestionnaires on 203 patients. For a subsample of 38 patients, hospital rec ords were reviewed and compared with the GP survey data. Results: For 52% (105/203) of all patients the GP was not notified of hospi tal admission. Medication management was documented in the discharge plan f or 13% (5/38) of the subsample. Communication in both directions between GP and hospital about medications was recorded for 13% (5/38) of the subsampl e. Consultation with the GP about the patient's medication during the hospi tal stay occurred for 11% (22/203) of all patients and 24% (9/38) of the su bsample. Ninety-one per cent of patients (185/203) were discharged with suf ficient medication to last until they saw their GP. Fewer than 10% of patie nts received all the information the Guidelines require. For 33% (66/203) o f the patients, GPs considered there was at least one barrier leg, language , cultural) to understanding the medication regimen. Conclusions: Compliance with the Guidelines is not good at present. Their a cceptance may be strengthened by formulating specific target indicators. A minimum indicator would be notifying the GP of three out of four matters: t he patient's admission; medications on discharge; medication changes; and f ollowup arrangements.