Pharmacists´ participation in the documentation of medication history in a developing setting: An exploratory assessment with new criteria

Yusuff, Kazeem B.; Tayo, Fola; Aina, B A

doi:10.4321/s1886-36552010000200009

Cited by 7 publications

(8 citation statements)

References 21 publications

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“…The second most common discrepancy we found was due to OTC and herbal medications that needed to be added to the medication list, which was also seen in other outpatient studies. 6 , 7 , 9 , 10 , 13 This is concerning due to the potential for numerous drug-drug and drug-disease interactions with OTC and herbal products, particularly in patients who are self-treating without the knowledge of their primary care physician. There were also a significant number of prescription medications from outside providers which needed to be documented in the medication list.…”

Section: Discussionmentioning

confidence: 99%

“…Yusuff and colleagues noted that pharmacist involvement significantly increased the quality and quantity of medication information that was documented. 13 An inpatient study led by Mergenhagen compared medication reconciliation by pharmacists to physicians and found that medication reconciliation by pharmacists was more comprehensive and led to lower odds of adverse drug events related to admission prescribing changes. 14 Another inpatient study by Lancaster and colleagues demonstrated the value of student pharmacists in the inpatient reconciliation process.…”

Section: Introductionmentioning

confidence: 99%

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A retrospective review of student pharmacist medication reconciliation activities in an outpatient family medicine center

Andrus

Anderson

2015

Pharm Pract (Granada)

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Background:Medication reconciliation in the outpatient setting is an important part of preventing medication errors, and is mandated by the Joint Commission.Objective:To describe and quantify medication reconciliation efforts by student pharmacists in an outpatient family medicine center.Methods:A retrospective review was conducted of medication reconciliation documentation forms completed by student pharmacists during an outpatient clinical rotation between May 2012 and April 2013. Discrepancies were defined as any lack of agreement between the medication list in the electronic medical record and the patient reported regimen. Descriptive statistics were used to report results.Results:A total of 557 medication reconciliation documentation forms from 12 student pharmacists were reviewed. The average number of medications per patient interviewed was 9 (range 0-25). A total of 1,783 medication discrepancies were found with an average of 3.2 discrepancies per patient. An additional 272 medication allergy discrepancies were identified. The most common discrepancy was medications the patient was no longer taking (37.3%, n=766). The second most common discrepancy was over-the-counter and herbal medications that had not been added to the medication list (16.2%, n=335). Patient counseling was documented 159 times during the medication reconciliation process.Conclusions:Medication reconciliation by student pharmacists in an outpatient family medicine center resulted in the identification of many discrepancies in medication lists in an electronic health record. Student pharmacists also documented and clarified medication allergies and performed patient counseling.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A retrospective review of student pharmacist medication reconciliation activities in an outpatient family medicine center

Andrus

Anderson

2015

Pharm Pract (Granada)

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“…In an outpatient study performed in Nigeria by Yusff and colleagues, pharmacist involvement in medication histories for 324 patients significantly increased the frequency and depth of medication information documented 9. Documentation of prescription drugs increased from 68.9% at baseline to 100% after pharmacist intervention, over-the-counter medication documentation increased from 25.1% to 96.9%, and herbal drug use documentation increased from 10.7% to 85.5% (p=0.0001 for all).…”

Section: Introductionmentioning

confidence: 97%

Student pharmacist initiated medication reconciliation in the outpatient setting

Andrus

2012

Pharmacy Practice (Internet)

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The Joint Commission continues to emphasize the importance of medication reconciliation in all practice settings. Pharmacists and student pharmacists are uniquely trained in this aspect of patient care, and can assist with keeping accurate and complete medication records through patient interview in the outpatient setting. Objective The objective of this study was to quantify and describe medication reconciliation efforts by student pharmacists in an outpatient family medicine center. Methods A retrospective review was conducted of all standard medication reconciliation forms completed by student pharmacists during patient interviews from April 2010 to July 2010. The number of reviews conducted was recorded, along with the frequency of each type of discrepancy. A discrepancy was defined as any lack of agreement between the medication list in the electronic health record (EHR) and the patient-reported regimen and included any differences in dose or frequency of a medication, duplication of the same medication, medication no longer taken or omission of any medication. Results A total of 213 standard medication forms from the 4 month period were reviewed. A total of 555 discrepancies were found, including medications no longer taken, prescription medications that needed to be added to the EHR, over-the-counter(OTC) and herbal medications that needed to be added to the EHR, medications taken differently than recorded in the EHR, and medication allergies which needed to be updated. An average of 2.6 discrepancies was found per patient interviewed. Conclusions Student pharmacist-initiated medication reconciliation in an outpatient family medicine center resulted in the resolution of numerous discrepancies in the medication lists of individual patients. Pharmacists and student pharmacists are uniquely trained in medication history taking and play a vital role in medication reconciliation in the outpatient setting.

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“…Health professionals should document appropriately to minimize or eliminate medication errors. Pharmacists' participation in medication history documentation might significantly increase the frequency and depth of medication history information documented [24]. UNTH had more interventions and known outcomes of interventions than Medical Centre.…”

Section: Resultsmentioning

confidence: 99%

Evaluation of Drug Therapy Problems in Asthma Patients Receiving Care in Two Hospitals in South-Eastern Nigeria

Amorha

Onu

Anene-Okeke

et al. 2018

Int J Pharm Pharm Sci

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Objective: To evaluate drug therapy problems in asthma patients visiting a secondary and tertiary hospital in South-Eastern Nigeria.Methods: This study was a retrospective, cross-sectional analyses of the medical records of adult asthmatic patients receiving care in two hospitals in Enugu State, within a 15-year period. The Pharmaceutical Network Care Europe (PCNE) tool version 6.2 was used to assess drug therapy problems. The IBM Statistical Product for Services Solution (SPSS) version 20.0 was used for analysis. For all results, P ≤ 0.05 was considered statistically significant.Results: Majority of the patients were below 60 y old (81.2%); female (68.8%) and were on more than two drugs (95.3%). Majority of the identified drug therapy problems (DTPs) were adverse reactions (65.7%). The inappropriate drug combination was the major cause of DTPs (65.6%). Only about 23.4% of the intervention outcomes were known. University of Nigeria Teaching Hospital (UNTH) had more interventions (35.9%) than Medical Centre (8.0%) (χ2 = 6.323; df = 1; **P = 0.012); and more of the outcomes of their interventions known (38.5%) compared to Medical Centre (0.0%) (χ2 = 12.559; df = 1; **P ˂ 0.001).Conclusion: Adverse reactions and inappropriate drug selection were the major identified DTPs and major cause of DTPs, respectively. Most DTPs had no interventions. The documented interventions included stopping of the drugs, change of drugs or dosage, change of instructions for use and starting of new drugs. Most interventions had unknown outcomes. UNTH had more interventions with known outcomes than the University of Nigeria Medical Centre.

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Pharmacists´ participation in the documentation of medication history in a developing setting: An exploratory assessment with new criteria

Cited by 7 publications

References 21 publications

A retrospective review of student pharmacist medication reconciliation activities in an outpatient family medicine center

A retrospective review of student pharmacist medication reconciliation activities in an outpatient family medicine center

Student pharmacist initiated medication reconciliation in the outpatient setting

Evaluation of Drug Therapy Problems in Asthma Patients Receiving Care in Two Hospitals in South-Eastern Nigeria

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