In the intensive care units of hospitals everywhere, patients fight for their lives against serious disease while teams of clinicians work around the clock, doing whatever it takes to stabilize them. But what happens to these patients once they leave this high stakes environment?

For many, the intense juggling act of the ICU gives way to “a series of dropped balls”, says Theodore J. Iwashyna, M.D., Ph.D., professor of critical care medicine at the University of Michigan and a staff physician at the VA Ann Arbor. He, along with collaborators Antoinette Coe, PharmD, Ph.D. of the U-M College of Pharmacy and Brenda Vincent of the Center for Clinical Management Research with the U.S. Department of Veterans Affairs, reveal important lapses in medication reconciliation, the rate at which patients resume taking necessary medications and stop taking unnecessary ones prescribed during their hospitalization.

Using a data set of more than a million patients from the VA health system who were discharged after a hospitalization, they examined prescription fill rates for two important drugs: statins, heart drugs that are often stopped by care teams during hospitalization; and antipsychotics, which are commonly prescribed for hospital-induced delirium. This is the first time this has been done in a national hospital system.

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