Drug history (DH) • Current prescription medications (dose, frequency, duration of use) • Current OTC and herbal medications (dose, frequency, duration of use) • Medications used in the last 1-2 years, including reason for discontinuation • Allergies, including specific reaction • Adverse drug reactions Medication reconciliation is the process of creating the most accurate list possible of all medications a patient is taking including drug name, dosage, frequency, and route, and comparing that list against the admission, transfer, and/or discharge orders, with the goal of preventing unintended chnages or omissions during transition points. multiple brands of the same medicine), The patient’s understanding of the medicines, Patient adherence with medications, including assessing the need for dose administration aids, Non-pharmacological management and lifestyle factors, Vaccination status for influenza and pneumococcus, Need for medical alert bracelet for e.g., anticoagulants or allergies, Currently taking 5 or more regular medications, Taking more than 12 doses of medication per day, Significant medication changes in the last 3 months, Medication with a narrow therapeutic index or requiring therapeutic monitoring, Symptoms suggestive of an adverse drug reaction (ADR), Suspected non-compliance or inability to manage medication-related therapeutic devices, Difficulty managing medicines because of literacy or language difficulties, dexterity problems, impaired sight or cognitive difficulties (confusion, dementia), Attending a number of different doctors, both GPs and specialists. nose/ear/eye drops, pessaries, suppositories), Other people’s medicine (e.g., family members in the same household), Intermittent medicines (e.g., weekly or twice a week), The suitability of each medicine, using available evidence to guide treatment choice and dose, The need for additional therapy for untreated conditions, Potential unwarranted therapy: e.g., medication where there is no current medical indication, or with an unnecessary duration of treatment, Tests required for therapeutic efficacy or to detect adverse effects and toxicity, Duplication of medicines (e.g,. It is also intended to drive a new communitywide Mohd. Select the Form Status and click on the Search button. Your practice may also add it to chart note protocols to make it easy to review medications as you chart a visit. Once a medication history has been taken and medication lists reconciled, the following elements should be identified: Engagement of the patient may be aided by explaining the purpose, process and possible outcomes of the review prior to the consultation, asking the patient to bring their medicines (or a list of their medicines) and encouraging the patient to ask questions and actively involve themselves in the discussion. And these errors and missing information can have a significant impact on patient care and the cost of care. CDER professionals participate in several meetings, conferences and workshops throughout the year. Rafi Bhat • Monitor completion of lab work. Assist physician to select drug product, dosage form and schedules. Longitudinal 3. Taking medication histories can be difficult. ABOUT AUTHORS: Jyoti Malik Hindu College of Pharmacy, Sonepat, Haryana jyotimalik127@gmail.com ABSTRACT: There was a need for delivery systems that could maintain a steady release of drug to the specific site of action. Click on the Report link beside the Medication History option under the Health tab. Medication histories are important in preventing prescription errors and consequent risks to patients. You can filter the list to display only active medications, if you prefer. An accurate record of all medicines taken, including prescribed and non-prescribed, over-the-counter and complementary medicines, is fundamental to a medication assessment and an essential basis for subsequent decision-making. Meeting Presentations. GPs are often central in coordinating medication management. TARGETS Systems and structures surrounding drug use Processes of drug use Outcomes of drug use TYPES Quantitative Qualitative 1. A medication review process should give the patient an opportunity to raise any concerns and ask questions about their medications. How to Take a Medication History | OSCE Guide | Geeky Medics 7. Guiding principles for medication management in the community. OTC cough and cold medicines may contain sympathomimetics that can oppose the benefits of beta-blockers, precipitate arrhythmias and elevate BP. In 2001, persons in the United States younger than 65 purchased a mean of 10.8 prescription drugs and those 65 or older purchased a mean … Obtaining a medication history The Medication Review Policy requires that medication reconciliation, including an accurate medication history, is conducted for all inpatients. Medication History Technicians are a valuable team member in the patient admission and medication reconciliation process. medication history possible and was chosen by community stakeholders. Where resources do not allow for regular medication review of all patients, prioritise high risk patients. Medication reconciliation involves a three-step process: verification (collecting an accurate medication history); clarification (ensuring that the medications and doses are appropriate); and reconciliation (documenting every single change and making sure it “squares” with all the other medication … You can change your ad preferences anytime. Step 05 - Drug History (DH) Find out what medications the patient is taking, including dosage and how often they are taking them, for example: once-a-day, twice-a-day, etc. Given the large number of generic medicines for CVD, dedicate some time to discuss potential confusion over brands. The module is designed for junior medical officers, nursing and pharmacy staff, and includes a short role-play scenario. 1. By default, the Medication History appears on the Medical Summary. Obtaining an accurate and comprehensive medication history and information about medication risk is important to inform decision-making and the plan for ongoing care. • Provide medication resources for Michael (e.g., pharmacy number, educational material). … At this point it is a good idea to find out if the patient has any allergies. The process involves ensuring patients receive the most appropriate treatments for their condition at a safe and appropriate dose, while minimising the risks associated with medication use. Terms and Conditions Non-prescribed medicines should also be recorded. Each medication is displayed along with it… Types of drug information Drug based information Problem or encounter-based information Patient information Prescriber information 11. The extent and frequency of a medication review should be guided by the individual patient needs. Huile Gao, in Brain Targeted Drug Delivery System, 2019. Many countries provide a funded medication review … See our User Agreement and Privacy Policy. The Australian Pharmaceutical Advisory Council suggests the following patient criteria predisposed to medication-related problems:[#australian-pharmaceutical-advisory-council-apac.-2006]. The patient record, including the pharmacist’s review, patient medication history list and patient summary, will then be compiled and sent HEALTHeLINK to perform a comprehensive medication review for high risk diabetic patient’s data and recommend any medication regimen modification necessary for the patient to meet the standard of care. Medication history-taking and medicines reconciliation. Many countries provide a funded medication review service. Medication reviews are most often undertaken by doctors, pharmacists and nurses, and may occur during outpatient clinics, home visits, exercise rehabilitation programs, or via the telephone. Clipping is a handy way to collect important slides you want to go back to later. This should be completed by an appropriately credentialed professional, by the end of the next calendar day (ENCD) after admission and balanced against patient risk. If you continue browsing the site, you agree to the use of cookies on this website. Completing a best possible medication history (BPMH) is a crucial first step in the medication reconciliation process. How medication history-taking techniques can influence the accuracy of the history obtained. Abstract. For example, over-the-counter (OTC) NSAIDs such as ibuprofen may increase the risk of MIs, reduce the efficacy of aspirin in preventing MIs, and increase the risk of acute renal failure associated with ACE inhibitors and have the potential to exacerbate HF. These results suggest that the medication history taking the triple therapy may be a marker of disease severity in medication aspect of COPD. • Encourage Michael to “ask the right questions” at his doctor’s appointments. MEDICATION HISTORY INTERVIEW A medication history is a detailed , accurate and complete account of all prescribed and non-prescribed medications that a patient had taken or is currently taking prior to a initially institutionalized or ambulatory care . Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. See our Privacy Policy and User Agreement for details. Assistant Professor If you continue browsing the site, you agree to the use of cookies on this website. Therefore, drug delivery systems were developed to optimize the therapeutic properties of drug products and render them more safe, effective, and reliable. Dr. KANCHAN VOHRA Medication history technicians have been shown to effectively document medication histories using structured patient interviews and standardized forms and processes. Some errors result from what psychologist James Reason would term an unsafe act15—an action that violates a policy or procedure but may be done to save time. Videos are available from the NPS MedicineWise website and … List the names of each drug, how it is used/taken and any potential side effects. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Looks like you’ve clipped this slide to already. 1. Examples of herbal or complementary supplements with potential interactions or relevance for patients with ACS include: Of particular concern is that complementary medicines bought online from some countries may not have undergone the same rigorous quality assurance, and thus may contain different or additional ingredients to those listed on the packaging. In 2010, the National Patient Safety Agency issued a rapid response report about the importance of avoiding missed doses of medicines, highlighting the need to identify a list of critical medicines (including some long-term medici… The Medication History component shows all of a patient’s prescribed and reported medications. Submitted To : Disclaimer No public clipboards found for this slide. Role of the clinical pharmacist in medication safety Prescription monitoring. Patient education and counseling. Medication errors are defined as the preventable inappropriate use of medications. For example, See Cautions and monitoring for more information. Australian Pharmaceutical Advisory Council (APAC). Herbal and complementary supplements should also be recorded as they may have particular relevance for people with cardiac disease. June 2006. Select the individual Name from the dropdown and specify a time period by entering Begin Date and End Date. You will be directed to the list of Medication History Reports matching the parameters entered. Another important part of a medication history is the patient's use of nonprescription medications and herbal preparations. Disclaimer: Certain information may not be available or accurate in this report, including items that the patient asked not be disclosed due to patient privacy concerns, over the-counter medications, low cost prescriptions, prescriptions paid for by the patient or nonparticipating sources, or errors in insurance claims information. Using a standardized method for taking medication histories is vital … A Best Possible Medication History (BPMH) is a medication history obtained by a healthcare provider which includes a thorough history of all regular medication use (prescribed and non-prescribed), using a number of different sources of information. Apart from preventing prescription errors, accurate medication histories are also useful in detecting drug-related pathology or changes in clinical signs that may be the result of drug therapy. Patient refuses to participate in medication history o Ask patient for pharmacy where fills and permission to call Ask pharmacy for meds filled in past 3-4 months Patient may fill 90day supply, so the most recent month may not be sufficient Patient reports methadone on medication list medication history, the fact remains that obtaining accurate medication history is a significant problem in health care, with up to 48 percent of all records having errors. The review should also aim to improve patient and carer understanding about their medicines to facilitate informed, shared decision-making regarding treatment. Acknowledge that medication safety is a topic and an understanding of the area will affect how you perform the following tasks: Use generic names where appropriate Tailor your prescribing for each patient Learn and practise thorough medication history taking Know which medications are high-risk and take precautions Medication errors may or may not have serious consequences. Ultimately, you want to assess potential interactions with currently prescribed medications. Cross-sectional study 2. Now customize the name of a clipboard to store your clips. Without an accurate medication history, prescribers may inadvertently make incorrect decisions about a patient’s treatment, causing harm if previously discontinued medicines are restarted, or if current medicines are omitted or prescribed at the wrong dose for the patient. • Update and review Michael’s medication chart. Medication lists (e.g., hospital admission medication history, inpatient medication chart, discharge medications, patients' medicines list, general practitioner (GP) record of medicines) should be reconciled at the relevant time points. These errors can occur at any point in the process: ordering, transcribing, dispensing, administering, or monitoring medications. The Australian Commission on Safety and Quality in Healthcare has a number of resources to support medication history and review. Over-the-counter complementary medications may also be more readily available for review in the home setting. Many patients don’t manage their own medications, and many of those who do struggle with drug names, doses, and indications. Interviewing patients at home helps identify issues such as expired, duplicated or medicines that have previously been stopped, as well as the storage conditions of medicines (e.g., GTN tablets). MEDICATION HISTORY INTERVIEW. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Submitted By : Some medication errors change a patient’s outcome, but the change d… As soon as you open a patient’s chart, you can review what medications they take in the Medication History component. • Remind Michael to take his medication chart with him to all physician visits. This Medication Toolkit is designed to improve your hospital’s current process for obtaining an accurate medication history by providing those responsible with the essential knowledge and tools needed. An important and novel finding in this study is the association between respiratory medication use and CT measurements, especially a history … Privacy Notice, © 2020 National Heart Foundation of Australia   ABN 98 008 419 761, australian-pharmaceutical-advisory-council-apac.-2006, Pathophysiology of Acute Coronary Syndrome and Heart Failure, Evidence and Principles of Exercise Training, Exercise Training Following a Recent Cardiac Event or Procedure, Education Topics For Cardiac Rehabilitation, Education Topics for Heart Failure Education, Australian Commission on Safety and Quality in Healthcare, Medicines that may be contraindicated or require precautions, #australian-pharmaceutical-advisory-council-apac.-2006, Encourage patients or carers to bring all their medicines or a list of medicines to the assessment, Contact the patient’s GP or local pharmacy if unsure about an accurate medication history, particularly where discrepancies are noted, Fish oil and krill oil potentially increase bleeding with antithrombotics, Liquorice potentially causes hypertension, and in regular high doses, may also cause hypokalemia, Ginkgo may cause hypotension, which may add to the hypotensive effects of ACE inhibitors, ARBs or beta-blockers, St John’s Wort interacts with many medicines, Warfarin interacts with numerous herbal and complementary supplements, Ginger, garlic, ginseng and ginkgo may increase bleeding risk and should not be used during dual anti platelet therapy (DAPT), Inhalers, puffers, sprays, sublingual tablets, Oral contraceptives, hormone replacement therapy, Gastrointestinal drugs (i.e., for reflux, heartburn, constipation, diarrhoea), Complementary medicines (e.g., vitamins, herbal or natural therapies), Topical medicines (e.g., creams, ointments, lotions, patches), Inserted medicines (e.g,. 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