Angela Wai1, Martina Salib2, Sohileh Aran3, James Edwards4, Asad E Patanwala5. 1. Department of Pharmacy, Royal Prince Alfred Hospital, Level 5, Building 65, Missenden Road, Camperdown, 2050, Australia. Electronic address: Angela.Wai@health.nsw.gov.au. 2. Department of Pharmacy, Royal Prince Alfred Hospital, Level 5, Building 65, Missenden Road, Camperdown, 2050, Australia. Electronic address: Martina.Salib@health.nsw.gov.au. 3. Department of Pharmacy, Royal Prince Alfred Hospital, Level 5, Building 65, Missenden Road, Camperdown, 2050, Australia. Electronic address: Sohileh.Aran@health.nsw.gov.au. 4. Department of Emergency Medicine, Royal Prince Alfred Hospital, Level 5, Building 65, Missenden Road, Camperdown, 2050, Australia. Electronic address: James.Edwards@health.nsw.gov.au. 5. Department of Pharmacy, Royal Prince Alfred Hospital, Level 5, Building 65, Missenden Road, Camperdown, 2050, Australia; School of Pharmacy, University of Sydney, Pharmacy and Bank Building (A15), Camperdown Campus, Sydney, New South Wales 2006, Australia. Electronic address: asad.patanwala@sydney.edu.au.
Abstract
OBJECTIVES: The primary objective of this study was to determine the proportion of patients with medication discrepancies when using a self-administered medication history form in the emergency department (ED). The secondary objectives were to identify predictors of medication discrepancies and determine the proportion of patients with a high-risk medication discrepancy. METHODS: This was a cross-sectional study conducted in an urban ED in Australia. Patients completed a self-administered medication history form while waiting to be seen by a physician. Subsequently, a best possible medication history was taken by a pharmacist to determine accuracy of the self-reported medication lists for patients with planned admissions. Discrepancies between the two medication lists were reported descriptively. A Poisson regression analysis was conducted to identify predictors of the rate of discrepancies. Associations were reported as incident rate ratios (IRR). RESULTS: A total of 138 patients were included in the study. The total number of discrepancies was as follows: 0 (25%, n = 34), 1 (34%, n = 47), 2 (11%, n = 15), and ≥3 (30%, n = 42). The number of medications (IRR 1.11, 95% CI 1.09 to 1.14, p < 0.001), female (IRR 1.51, 95% CI 1.18 to 1.92, p = 0.001), and missing community pharmacy information (IRR 2.10, 95% CI 1.64 to 2.68, p < 0.001) were significantly associated with rate of discrepancies. Overall, 20% (n = 28) of patients had one or more high-risk medication discrepancies. CONCLUSION: Patient self-administered medication history forms have a high rate of discrepancies and should be verified by a best possible medication history.
OBJECTIVES: The primary objective of this study was to determine the proportion of patients with medication discrepancies when using a self-administered medication history form in the emergency department (ED). The secondary objectives were to identify predictors of medication discrepancies and determine the proportion of patients with a high-risk medication discrepancy. METHODS: This was a cross-sectional study conducted in an urban ED in Australia. Patients completed a self-administered medication history form while waiting to be seen by a physician. Subsequently, a best possible medication history was taken by a pharmacist to determine accuracy of the self-reported medication lists for patients with planned admissions. Discrepancies between the two medication lists were reported descriptively. A Poisson regression analysis was conducted to identify predictors of the rate of discrepancies. Associations were reported as incident rate ratios (IRR). RESULTS: A total of 138 patients were included in the study. The total number of discrepancies was as follows: 0 (25%, n = 34), 1 (34%, n = 47), 2 (11%, n = 15), and ≥3 (30%, n = 42). The number of medications (IRR 1.11, 95% CI 1.09 to 1.14, p < 0.001), female (IRR 1.51, 95% CI 1.18 to 1.92, p = 0.001), and missing community pharmacy information (IRR 2.10, 95% CI 1.64 to 2.68, p < 0.001) were significantly associated with rate of discrepancies. Overall, 20% (n = 28) of patients had one or more high-risk medication discrepancies. CONCLUSION:Patient self-administered medication history forms have a high rate of discrepancies and should be verified by a best possible medication history.
Authors: Freda M Warner; Jacquelyn J Cragg; Catherine R Jutzeler; Lukas Grassner; Orpheus Mach; Doris D Maier; Benedikt Mach; Jan M Schwab; Marcel A Kopp; John L K Kramer Journal: Neurology Date: 2020-09-28 Impact factor: 9.910