Table 1.

Outcome of all pre-admission medications recorded on discharge prescriptions and discharge summaries

Audit (n = number of prescriptions reviewed)	Total pre-admission medications	Prescribed	Omitted	Discontinued with explanation	Discontinued without explanation
Pre-intervention (n = 54)	436	299 (68.58%)	116 (26.61%)	10 (2.29%)	11 (2.52%)
Post-education (n = 54)	443	323 (72.91%)	85 (19.19%)	24 (5.42%)	11 (2.48%)
Post-EPR (n = 54)	339	312 (92.04%)	26 (7.67%)	1 (0.29%)	0 (0%)