Medication history taking on admission to a hospital emergency department

Iniesta Navalón C, Urbieta Sanz E, Gascón Cánovas JJ, Madrigal De Torres M, Piñera Salmerón P

Objectives: To determine the quality and accuracy of medication histories taken during

admission to the emergency department (ED) and to analyze the factors that may be

related to the presence of discrepancies.

Methods: Descriptive cross-sectional study. Patients over the age of 64 years were

enrolled on admission to the hospital from the during the last quarter of 2009. To detect

the presence of discrepancies we compared the medication histories taken by a clinical

pharmacist to the ones taken by an emergency physician on admission. Regression

analysis was used to identify factors associated with the presence of discrepancies.

Results: A total of 324 patients (53.4% women) with a mean age of 78.3 years were

enrolled. We detected 2928 discrepancies affecting 95.1% (95% confidence interval

[CI], 92.7%-97.4%) of the patients. The medication groups with the largest numbers of

discrepancies were antiulcer drugs (10.8%), antithrombotic drugs (9.5%), and

psycholeptics (7.2%). We detected discrepancies in the recording of 257 high-risk drugs

(8.8%) in 33.3% (95% CI, 28.2%-38.5%) of the patients. The only independent variable

associated with a higher prevalence of discrepancies was the use of multiple medications

(odds ratio, 8.02 (95% CI, 2.79-23.02).

Conclusion: Our findings demonstrate that there is ample room for improvement, on

medication history taken at ED, and increased cuation should be taken for patients of

advanced age and those taking multiple medications.

Gascón Cánovas JJ, Iniesta Navalón C, Madrigal De Torres M, Piñera Salmerón P, Urbieta Sanz E