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Tuesday / August 16.
HomeminewsPharmacist Highlights Importance of Medication History

Pharmacist Highlights Importance of Medication History

Documenting a patient’s medication is an important part of taking a medical history, yet according to clinical pharmacist and Adjunct Assoc. Professor Geraldine Moses, few eye care professionals have been taught how to do it properly.

Dr. Moses, who will present a lecture for optometrists at a Queensland University of Technology Masterclass on Sunday 11 March, says it is possible to do a better job of documenting patient medications, without spending too much time.

“Currently, most people just write down whatever they can while the patient tries to remember what they take or fumbles with a scratchy piece of paper from their wallet. ‘I know I take a white one’ is a common refrain. When reviewing medication profiles taken by other health professionals I often see only drug names documented e.g. ‘Patient takes aspirin, metoprolol and glucosamine’. Knowing the drug names is only part of the story. Look at the huge difference between knowing a person is just on prednisone, versus 50mg prednisone daily for three days versus 5mg prednisone for three years. Adding the dose and duration makes all the difference,” said Dr. Moses.

“In pharmacy, we have turned medication history-taking into an art form. We pride ourselves in creating what is called a Best Possible Medication History (BPMH), which takes about an hour and half to complete. A BPMH is most often required for hospitalised patients who arrive for unplanned admissions with no information about their medication. But frankly, everyone could do with a BPMH.”

Currently, most people just write down whatever they can while the patient tries to remember what they take or fumbles with a scratchy piece of paper from their wallet. ‘I know I take a white one’ is a common refrain

A BPMH is defined by the Australian Commission on Safety and Quality in Health Care as: ‘An accurate recording of a patient’s medicines. It comprises a list of all current medicines including prescription and non-prescription medicines, complementary healthcare products and medicines used intermittently; recent changes to medicines; past history of adverse drug reactions including allergies; and recreational drug use’.

Dr. Moses said although there isn’t sufficient time in a busy optometry practice to delve into people’s medications, the following essential details should be documented:

Three Things for Each Drug

For each medicine specify the drug name, dosage and duration of treatment. To document this, it helps to use a table, divided into three columns (+/-a fourth for notes) as this will automatically prompt you and/ or the patient for the necessary information. Asking patients to complete this form before their appointment can be most efficient and accurate, as they won’t have to rely on memory and can ask their pharmacist or doctor for assistance.

Prescription and Non-prescription

Start by asking about prescription drugs, but once completed, move onto non-prescription medicines, including those purchased in a pharmacy, supermarket, health shop, from a naturopath or on-line.

Non Oral Meds

Repeat the above for regularly used non-oral medication, including, eyedrops, ear drops, inhalers and puffers, injections, implants, and dermatologicals.

‘As Required’ Meds

Ask about medicines that are used when required or ‘prn’ – these are usually for symptom relief, so focus on medicines used for dry eyes, pain, gastric reflux, sleep etc.

Recreational and Lifestyle Meds

Consumption of alcohol, caffeine, marijuana and tobacco smoking should be quantified. Recreational drugs and lifestyle medicines, such as those for hair loss or erectile dysfunction may occasionally impact on the patient’s diagnosis, so need to be adequately documented.

Recently Ceased Meds

Recently used medicines can alter the presentation of some symptoms, so document whether the patient has recently taken or just finished antibiotics or another type of medicine.

Other People’s Medicines

This is useful to know, as it is not uncommon for friends, family and spouses to share their medicines!

Dr. Moses said although it can be tempting to simply ask a patient to bring in a list of meds from their GP, this will never be comprehensive. “That’s a good place to start, but it usually only documents that particular GP’s prescribing, and won’t include medicines from other doctors, nonmedical professionals, non-prescription or complementary medicines.”

Instead, collecting and collating information directly from the patient will give an extremely good idea of the medication and other pharmacological substances he/she uses in their daily life. “Not only is this is a more appropriate basis on which to make health care decisions, but you also find out how they use their medicines, their attitudes and beliefs towards medication, and whether they are likely to adhere to treatment which can provide useful insight into treatment planning,” said Dr. Moses.

To see the full QUT Masterclass program and register, visit www.masterclass2018.com

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