A simple tool to improve medication reconciliation at the emergency department. 2011

Sabrina De Winter, and Peter Vanbrabant, and Isabel Spriet, and Didier Desruelles, and Christophe Indevuyst, and Daniel Knockaert, and Jean Benard Gillet, and Ludo Willems
Pharmacy Department, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium. sabrina.dewinter@uzleuven.be

BACKGROUND Medication histories acquired upon admission are often incomplete. Using a standardized approach warrants more complete medication reconciliation, however, this is too time consuming to be performed. Other strategies guaranteeing complete medication histories should be explored. We developed a limited list of standardized questions and assessed its impact on completeness of medication histories. METHODS This prospective study enrolled adults presenting to a tertiary care emergency department. In the control group, medication histories were conducted by physicians of general internal medicine conform standard care. In the intervention group, the physicians were obliged to use, besides the standard care, the 'limited questions list' for medication history acquisition. The clinical pharmacist re-obtained medication histories of the patients in both groups using a standardized approach. The primary outcome was the impact of the use of a 'limited questions list' on the frequency of drug omissions in medication histories. RESULTS 260 consecutive patients were enrolled: 130 in the intervention group and 130 in the control group. There was a significant reduction of 49.3% in drug omissions in the intervention group. The omission rate per medication history was 1.1 for the control group, which was significantly lower (0.6) in the intervention group. Antithrombotics were most frequently forgotten in the control care group as opposed to dietary supplements in the intervention group. CONCLUSIONS Drug omission rate in medication histories can be significantly reduced if a limited list of simple questions is used during anamnesis. Widespread use of this tool should be considered to be implemented.

UI MeSH Term Description Entries
D008297 Male Males
D008487 Medical History Taking Acquiring information from a patient on past medical conditions and treatments. Medical History, Previous,Past Medical History, Family,Previous Medical History,Family Health History,Family History, Health,Family History, Medical,Family Medical History,History Taking, Medical,Family Health Histories,Family Medical Histories,Health Family Histories,Health Family History,Health History, Family,History, Previous Medical,Medical Family Histories,Medical Family History,Medical Histories, Previous,Medical History, Family,Previous Medical Histories
D008508 Medication Errors Errors in prescribing, dispensing, or administering medication with the result that the patient fails to receive the correct drug or the indicated proper drug dosage. Drug Use Error,Errors, Medication,High-Alert Drug Error,High-Alert Medication Error,LASA Medication Errors,Look-Alike Drug Name Errors,Look-Alike Sound-Alike Drug Errors,Look-Alike Sound-Alike Drug Substitution Errors,Look-Alike Sound-Alike Medication Errors,Lookalike Drug Name Errors,Lookalike Soundalike Drug Errors,Lookalike Soundalike Drug Substitution Errors,Lookalike Soundalike Medication Errors,Drug Error, High-Alert,Drug Use Errors,Error, Drug Use,Error, LASA Medication,Error, Medication,High Alert Drug Error,High Alert Medication Error,High-Alert Drug Errors,High-Alert Medication Errors,LASA Medication Error,Look Alike Drug Name Errors,Look Alike Sound Alike Drug Errors,Look Alike Sound Alike Drug Substitution Errors,Look Alike Sound Alike Medication Errors,Medication Error,Medication Error, High-Alert,Medication Error, LASA,Medication Errors, High-Alert,Medication Errors, LASA
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010343 Patient Admission The process of accepting patients. The concept includes patients accepted for medical and nursing care in a hospital or other health care institution. Voluntary Admission,Admission, Patient,Admission, Voluntary,Admissions, Patient,Admissions, Voluntary,Patient Admissions,Voluntary Admissions
D010607 Pharmacy Service, Hospital Hospital department responsible for the receiving, storing, and distribution of pharmaceutical supplies. Clinical Pharmacy Service,Hospital Pharmacy Service,Pharmacy Service, Clinical,Hospital Pharmaceutic Service,Hospital Pharmaceutical Service,Hospital Pharmacy Services,Pharmaceutic Service, Hospital,Pharmaceutical Service, Hospital,Service, Clinical Pharmacy,Service, Hospital Pharmaceutic,Service, Hospital Pharmaceutical,Service, Hospital Pharmacy,Clinical Pharmacy Services,Hospital Pharmaceutic Services,Hospital Pharmaceutical Services,Pharmaceutic Services, Hospital,Pharmaceutical Services, Hospital,Pharmacy Services, Clinical,Pharmacy Services, Hospital,Services, Clinical Pharmacy,Services, Hospital Pharmaceutic,Services, Hospital Pharmaceutical,Services, Hospital Pharmacy
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D004630 Emergencies Situations or conditions requiring immediate intervention to avoid serious adverse results. Emergency
D004636 Emergency Service, Hospital Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient. Emergency Outpatient Unit,Emergency Services Utilization,Hospital Emergency Room,Hospital Emergency Service,Hospital Emergency Services Utilization,Accident and Emergency Department,Emergency Departments,Emergency Hospital Service,Emergency Room,Emergency Units,Emergency Ward,Hospital Service Emergency,Service, Hospital Emergency,Department, Emergency,Departments, Emergency,Emergencies, Hospital Service,Emergency Department,Emergency Hospital Services,Emergency Outpatient Units,Emergency Room, Hospital,Emergency Rooms,Emergency Rooms, Hospital,Emergency Services, Hospital,Emergency Unit,Emergency Wards,Emergency, Hospital Service,Hospital Emergency Rooms,Hospital Emergency Services,Hospital Service Emergencies,Hospital Service, Emergency,Hospital Services, Emergency,Outpatient Unit, Emergency,Outpatient Units, Emergency,Room, Emergency,Room, Hospital Emergency,Rooms, Emergency,Rooms, Hospital Emergency,Service Emergencies, Hospital,Service Emergency, Hospital,Service, Emergency Hospital,Services Utilization, Emergency,Services Utilizations, Emergency,Services, Emergency Hospital,Services, Hospital Emergency,Unit, Emergency,Unit, Emergency Outpatient,Units, Emergency,Units, Emergency Outpatient,Utilization, Emergency Services,Ward, Emergency,Wards, Emergency
D005260 Female Females

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