Pharmacist elicited medication histories in the Emergency Department: Identifying patient groups at risk of medication misadventure

Pharmacy Practice

  • Maja Ajdukovic1School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.
  • Meredith Crook1School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.
  • Christopher Angley2Emergency Department, Royal Adelaide Hospital, Adelaide, Australia.
  • Ieva Stupans3Division of Health Sciences, University of South Australia, Adelaide, Australia.
  • Natalie Soulsby4Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.
  • Christopher Doecke5Royal Adelaide Hospital and School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.
  • Barbara Anderson4Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.
  • Manya Angley4Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.

Volume 5 Issue 4 Pages 162-168

Abstract

Objective: To analyse the incidence of discrepancies in medication histories in these demographic groups when pharmacist elicited medication histories were compared with those taken by ED physicians. It also aimed to investigate the incidence of medication related ED presentations. Methods: The study was conducted over a six week period and included 100 patients over the age of 70, who take five or more regular medications, have three or more clinical co-morbidities and/or have been discharged from hospital in three months prior to the study. Results: Twenty four participants were classified as 'language barrier'; 12 participants were from residential aged care facilities, and 64 participants were classified as 'general'. The number of correctly recorded medications was lowest in the 'language barrier' group (13.8%) compared with 18% and 19.6% of medications for 'general' patients and patients from residential aged care facilities respectively. Seven of the patients (29.2%) with 'language barrier'; 1 from a residential aged care facility (8.3%) and 13 of the (20.3%) patients from the 'general' category were suspected as having a medication related ED presentation. Conclusion: This study further highlights the positive contribution an ED pharmacist can make to enhancing medication management along the continuum of care. This study also confirms the vulnerability of patients with language barrier to medication misadventure and their need for interpreter services at all stages of their hospitalisation, in particular at the point of ED presentation.

Keywords

  • Medication Errors
  • Pharmaceutical Services
  • Medical Records
  • Communication Barriers
  • Australia
Pharmacy Practice

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