The interplay between multimorbidity, care transitions and medicines safety in acute care
Supervisors:
Prof Nazir Lone, Usher Institute (University of Edinburgh)
Dr Daniel Morales, School of Medicine (University of Dundee)
Summary:
Acute hospitalisation is a high-risk period for medication errors and subsequent adverse events. People with multiple long-term conditions face particular challenges due to polypharmacy and greater care complexity, which increases the risk of medication discrepancies/errors.
Datasets are now available that bring together granular data relating to in-hospital care transitions, adverse event reporting systems and prescribing allowing novel insights to be surfaced.
The overall aim of the fellowship is to evaluate the scale and impact of medication discrepancies and subsequent adverse events across the care pathway during acute hospitalisation. The work will inform future work to implement improvements in medicines safety.
The specific objectives are to:
1. Investigate the epidemiology of medication discrepancies and adverse outcomes at specific transitions in the acute care pathway in people with multiple long-term conditions.
2. Model care pathway trajectories using multistate models to quantify the effect of risk factors on changes in health status defined by medication discrepancies and adverse outcomes.
3. Investigate the effect of medication discrepancies on adverse outcomes and whether this varies by multimorbidity.
The fellow will receive methodological training in handling large datasets, epidemiology, statistical modelling, causal inference, and pharmacoepidemiology, benefitting from the vibrant, academic environment in the Usher Institute.