Objectives: Medication error prevention has become a priority in health care. The Joint Commission recommends that a list of medications, dosages, and allergies be obtained from all patients. The authors sought to determine the accuracy of medication history taking in emergency department (ED) triage. The hypothesis was that there would be significant discrepancies between medications listed in triage and those the patient was actually taking. Methods: This was a prospective, cross-sectional survey of adult patients presenting to the ED. As a part of regular care, nurses recorded a medication list during triage in the electronic medical record (EMR). For this study, the triage medication list was rechecked during an independent patient interview. Results: Of 1,797 patients approached, 1,657 completed the survey (92%). The mean age was 39 years (standard deviation [SD] ±16 years). Discrepancies in medication lists obtained during triage were documented in 626 (37%) patients. Discontinued medications (163, 9.8%) were included, additional medications (463, 27.9%) were omitted, and 632 patients (38%) reported taking a nonprescription medication not listed in the EMR. Conclusions: Medication histories performed in ED triage are inaccurate and incomplete. ACADEMIC EMERGENCY MEDICINE 2011; 18:102-104 ª 2011 by the Society for Academic Emergency Medicine M edication errors are a major cause of morbidity and mortality. It is estimated that 9.7% of patients involved in an adverse drug event (ADE) have a resulting disability. 1 Patients who experience an ADE have twice the risk of death as those who do not. 2 The Institute of Medicine (IOM) estimates 1.5 million preventable ADEs occur annually, costing $3.5 billion per year. 3 ADEs translate into increased emergency department (ED) utilization. Approximately 177,000 ED visits by elders are attributed to drug misadventures annually. 4 These numbers are considered an underestimate, as many ADEs go unrecognized or unre-ported. The IOM report and the Joint Commission have made medication safety a priority in health care. Medication errors and adverse effects can occur any time in the patient encounter, 5 and the majority of ADEs can be prevented. 6 The Joint Commission recommends a list of medications, route, frequency, dosage, allergies, and adverse reactions be recorded, a process called medication reconciliation. It is hypothesized that accurate reconciliation prevents therapeutic duplications, drug omissions, drug-drug and drug-disease interactions , dosing errors, allergic reactions, and adverse effects. Medication lists are often inaccurate, and the limited available data suggest that medication reconciliation is often not complete in the ED. 7 This study attempts to evaluate the accuracy of medication histories performed during ED triage. We hypothesized that there would be significant discrepancies between medication lists obtained at triage and those medications patients were actually taking. We sought to determine the frequency of omitted medications , discontinued m...