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Pharmacist elicited medication histories in the Emergency Department: Identifying patient groups at risk of medication misadventure
Ajdukovic, Maja; Crook, Meredith; Angley, Christopher; Stupans, Ieva; Soulsby, Natalie; Doecke, Christopher; Anderson, Barbara; Angley, Manya.
Affiliation
  • Ajdukovic, Maja; University of South Australia. Adelaide. Australia
  • Crook, Meredith; University of South Australia. Adelaide. Australia
  • Angley, Christopher; Royal Adelaide Hospital. Adelaide. Australia
  • Stupans, Ieva; University of South Australia. Adelaide. Australia
  • Soulsby, Natalie; University of South Australia. Adelaide. Australia
  • Doecke, Christopher; University of South Australia. Hospital and School of Pharmacy and Medical Sciences. Adelaide. Australia
  • Anderson, Barbara; University of South Australia. School of Pharmacy and Medical Sciences. Sansom Institute. Adelaide. Australia
  • Angley, Manya; University of South Australia. School of Pharmacy and Medical Sciences. Sansom Institute. Adelaide. Australia
Pharm. pract. (Granada, Internet) ; 5(4): 162-168, oct.-dic. 2007. tab
Article in En | IBECS | ID: ibc-64307
Responsible library: ES15.1
Localization: ES15.1 - BNCS
ABSTRACT
The Australian Pharmaceutical Advisory Committee guidelines call for a detailed medication history to be taken at the first point of admission to an Emergency Department (ED). The elderly, in particular those residing in Residential Aged Care Facilities and those with a non-English speaking background, have been identified as patient groups vulnerable to medication misadventure.

Objective:

to analyse the incidence of discrepancies in medication histories in these demographic groups when pharmacist elicited medication histories were compared with those taken by ED physicians. It also aimed to investigate the incidence of medication related ED presentations.

Methods:

The study was conducted over a six week period and included 100 patients over the age of 70, who take five or more regular medications, have three or more clinical co-morbidities and/or have been discharged from hospital in three months prior to the study.

Results:

Twenty four participants were classified as 'language barrier'; 12 participants were from residential aged care facilities, and 64 participants were classified as 'general'. The number of correctly recorded medications was lowest in the 'language barrier' group (13.8%) compared with 18% and 19.6% of medications for 'general' patients and patients from residential aged care facilities respectively. Seven of the patients (29.2%) with 'language barrier'; 1 from a residential aged care facility (8.3%) and 13 of the (20.3%) patients from the 'general' category were suspected as having a medication related ED presentation.

Conclusion:

This study further highlights the positive contribution an ED pharmacist can make to enhancing medication management along the continuum of care. This study also confirms the vulnerability of patients with language barrier to medication misadventure and their need for interpreter services at all stages of their hospitalisation, in particular at the point of ED presentation (AU)
RESUMEN
Las guías del Comité Consultivo Farmacéutico Australiano establecen que se lleve una historia de medicación detallada desde el primer punto de entrada en un servicio de urgencias (SU). Los ancianos, en particular los que residen en Residencias de Ancianos y los que no son hablantes nativos ingleses, se han identificado como grupos de pacientes vulnerables a las desgracias medicamentosas.

Objetivo:

Analizar la incidencia de discrepancias en las historias de medicación en estos grupos demográficos cuando el farmacéutico obtuvo el historial farmacoterapéutico comparado con los recopilados por los médicos del Servicio de Urgencias. También trató de investigar la incidencia de visitas al SU relacionadas con medicamentos. Métodos. Este estudio se condujo en un periodo de seis semanas e incluyó 100 pacientes de edad superior a 70 años, que tomaban regularmente 5 o más medicamentos, tenían 3 o mas comorbilidades clínicas y/o habían sido dados de alta del hospital en los 3 meses anteriores al estudio.

Resultados:

24 participantes fueron calificados con 'barreras lingüísticas'; 12 participantes estaban en residencias de ancianos, y 64 participantes fueron calificados de 'generales'. El número de medicaciones correctamente registradas fue menor en los de 'barreras lingüísticas' (13,8%) comparado con el 18% y el 19,6% de las medicaciones para los 'generales' y los pacientes de residencias de ancianos, respectivamente. En 7 de los pacientes (29,2%) con 'barreras lingüísticas', 1 de residencias de ancianos (8,3%) y 13 (20,3%) de los 'generales' se sospechó que tenían una visita al SU relacionada con los medicamentos.

Conclusiones:

Este estudio ensalza la contribución positiva que un farmacéutico de urgencias puede realizar para elevar la gestión de la medicación en el continuum de cuidados. Este estudio también confirma la vulnerabilidad e los pacientes con barreras lingüísticas ante las desgracias medicamentosas y su necesidad de servicios de interpretes en todas las etapas de su hospitalización, en particular en el punto de entrada al SU (AU)
Subject(s)
Full text: Available Collection: National databases / Spain Database: IBECS Main subject: Chronic Disease / Medication Errors Type of study: Etiology study / Practice guideline / Prognostic study / Risk factors Limits: Aged / Female / Humans / Male Country/Region as subject: Oceania Language: English Journal: Pharm. pract. (Granada, Internet) Year: 2007 Document type: Article Institution/Affiliation country: Royal Adelaide Hospital/Australia / University of South Australia/Australia
Full text: Available Collection: National databases / Spain Database: IBECS Main subject: Chronic Disease / Medication Errors Type of study: Etiology study / Practice guideline / Prognostic study / Risk factors Limits: Aged / Female / Humans / Male Country/Region as subject: Oceania Language: English Journal: Pharm. pract. (Granada, Internet) Year: 2007 Document type: Article Institution/Affiliation country: Royal Adelaide Hospital/Australia / University of South Australia/Australia
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