Background: Various quality audits require information on medications prescribed at discharge for cardiac patients. Electronic capture of this information is more efficient than chart audit. In Queensland public hospitals, a data system called eLMS is widely used for pharmacy discharge data.
Methods: For the period 1/07/2009 to 31/12/2009, eLMS data for patients receiving a beta-blocker (BB), ace-inhibitor (ACEI), anti-platelet agent (AP), or lipid lowering agent (LL) were linked to data from Gold Coast Hospital patients discharged with acute myocardial infarction (AMI, ICD-10 codes I21.0-I21.9, I22.0-I22.9). A chart audit of a random sample of AMI patients was performed, and discharge medications reported from both sources were compared.
Results: Of the 309 AMI patients discharged in the period, 183 (59%) had an eLMS record. For the matched sample, general concordance of the findings from the two sources ranged from 94% for receiving an ACEI to 100% for receiving an AP medication. When assessed independently, similar proportions from the chart audit and the electronic sample were discharged with LL (94% vs 89%), BB (86% vs 83%) and AP (100% and 97%), respectively. The chart audit reported a statistically significant higher proportion of patients with ACEI (72% vs 61%, p<.05). Additional findings comparing patients with and without eLMS records will be reported.
Discussion: Reasons for discrepancies between the two sources will be elaborated. The benefits and limitations of using an electronic system to report discharge medication will be discussed.