The Australian
Pharmaceutical Advisory Committee guidelines call for a detailed
medication history to be taken at the first point of admission
to hospital. Accurate medication histories are vital in optimising
health outcomes and have been shown to reduce mortality rates.
This study aimed to examine the accuracy of medication histories
taken in the Emergency Department of the Royal Adelaide Hospital.
Medication histories recorded by medical staff were compared to
those elicited by a pharmacy researcher.
The study, conducted over a six-week period, included 100 patients
over the age of 70, who took five or more regular medications,
had three or more clinical co-morbidities and/or had been discharged
from hospital in three months prior to the study. Following patient
interviews, the researcher contacted the patient’s pharmacist
and GP for confirmation and completion of the medication history.
Out of the 1152 medications recorded as being used by the 100
patients, discrepancies were found for 966 medications (83.9%).
There were 563 (48.9%) complete omissions of medications. The
most common discrepancies were incomplete or omitted dosage and
frequency information. Discrepancies were mostly medications that
treated dermatological and ear, nose and throat disorders but
approximately 29% were used to treat cardiovascular disorders.
This study provides support for the presence of an Emergency Department
pharmacist who can compile a comprehensive and accurate medication
history to enhance medication management along the continuum of
care. It is recommended that the patient’s community pharmacy
and GP be contacted for clarification and confirmation of the
medication history.
Keywords:
Medication
Errors. Pharmaceutical Services. Medical Records. Australia.