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Discharge medicines reconciliation error — SCE Geriatric Medicine MCQ

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ModerateTransfer of careDischarge medicines reconciliation errorSCE Geriatric Medicine

An 89-year-old woman with frailty is discharged after heart failure treatment. She lives alone, has new need for help with transfers, mild cognitive impairment and eGFR 32 mL/min/1.73 m². Her medications changed during admission, but the discharge letter lists both furosemide and bumetanide; community carers start tomorrow. What is the most important next step?

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Correct answer: D — Complete medicines reconciliation and coordinated discharge communication with primary care and community services

Duplicate loop diuretic prescribing is a high-risk transition error, particularly with CKD and cognitive impairment. Safe transfer of care requires medicines reconciliation, clear communication and coordination with community services. Asking the patient to resolve contradictory instructions is unsafe. The pearl is that discharge planning in geriatrics is a clinical intervention, not an administrative endpoint.

Reference: NICE NG5 Medicines optimisation; NICE NG56; JRCPTB geriatric curriculum