Pharmacy-facilitated medication history program at a community teaching hospital: A pre-post study in an emergency department

Abstract

Purpose A study was conducted to compare the accuracy of medication histories compiled by pharmacy technicians with histories obtained through the usual multidisciplinary process. Methods A retrospective cohort study was conducted at a community teaching hospital from January 2017 through February 2018. Inclusion criteria included patient age of at least 18 years, use of 1 or more medications at the time of admission, and hospital admission through the emergency department. Each electronically documented medication history was assessed for accuracy. The objective was to compare the accuracy of pharmacy technician–collected medication histories to those obtained through the usual multidisciplinary process. Results Of 215 patients screened, 183 were included in the study: 91 patients whose medication histories were obtained through the usual multidisciplinary process and 92 whose medication histories were collected by pharmacy technicians. Overall, documentation for 1,773 medications listed in medication histories was reviewed. The primary outcome of medication history accuracy occurred 38% of the time with the usual multidisciplinary process and 70% of the time with pharmacy technician collection of medication histories (P < 0.001). Conclusion The study showed that the accuracy of medication histories was improved when histories were obtained by pharmacy technicians instead of via the usual multidisciplinary process.

What is the evidence that a pharmacy team working in an acute or emergency medicine department improves outcomes for patients: A systematic review

“…Of the included studies, 15 were non‐randomized controlled trials (NRCTs) 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 and two were randomized controlled trials (RCT), 36 , 37 all of which were available in English. The number of patients combined for all studies was 7630.…”

“…5457 (71.5%) participants were from four studies 25 , 26 , 28 , 30 within Europe. Two thousand one hundred and seventy‐three (28.5%) participants were from 13 studies 11 , 21 , 22 , 23 , 24 , 27 , 29 , 31 , 33 , 34 , 35 , 36 , 37 outside of Europe. Table 2 provides an overview of all studies within the review.…”

“…Two RCTs 36 , 37 both had a low risk of bias across five domains; see Figure 2 . For the 15 NRCTs, 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 seven of the studies 21 , 24 , 26 , 29 , 30 , 32 , 35 may have been affected by confounding variables. One of which was patient recruitment into the studies, as this was not reflective of all service users admitted into the hospital setting as some only included elderly patients or those who were prescribed two or more medications.…”

“…One of which was patient recruitment into the studies, as this was not reflective of all service users admitted into the hospital setting as some only included elderly patients or those who were prescribed two or more medications. 21 , 24 , 26 , 29 , 30 , 32 , 35 Selection bias could have moderately affected five of the studies 21 , 22 , 28 , 30 , 33 owing to changes occurring with the inclusion and exclusion criteria once the studies had commenced. A moderate level of outcome bias was noted for all 15 NRCTs owing to unclear and limited blinding of the participants.…”

“… Forest plot for nine studies 22 , 23 , 24 , 26 , 29 , 32 , 34 , 35 , 36 measuring medication errors. Medication errors for both arms were inclusive of any transcription errors compared to medication taken prior to admission to the acute or emergency medicine department.…”