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American Journal of Health-System Pharmacy, Vol. 63, Issue 24, 2500-2503
Copyright © 2006 by American Society of Health-System Pharmacists
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Notes

Pharmacist-acquired medication histories in a university hospital emergency department

Melinda K. Carter, Dennis M. Allin, Leigh Anne Scott and Dennis Grauer

MELINDA K. CARTER, M.S., PHARM.D., is Pharmacy Finance and Research Coordinator, Saint Luke’s Hospital, Kansas City, KS; at the time of the study she was Senior Pharmacy Practice Management Resident, Department of Pharmacy Practice, School of Pharmacy, University of Kansas (KU), Kansas City. DENNIS M. ALLIN, M.D., FACEP, is Chairman, Department of Emergency Medicine, School of FACEP Medicine, KU. LEIGH ANNE SCOTT, M.B.A, PHARM.D., is Assistant Director of Pharmacy, KU Hospital, Kansas City, and Clinical Assistant Professor, Department of Pharmacy Practice, School of Pharmacy, KU. DENNIS GRAUER, M.S., PH.D., PHARM.D., is Interim Chair and Assistant Professor, Department of Pharmacy Practice, School of Pharmacy, KU.

Address correspondence to Dr. Carter at the Department of Pharmacy, Saint Luke’s Hospital, 27240 West 135th Street, Olathe, KS 66061 (mkcarter{at}saint-lukes.org).


Purpose. A study was conducted to identify discrepancies between medication histories taken by emergency department (ED) providers (physicians, nurses, and medical students) and medication histories taken by clinical pharmacists.

Methods. During a three-month period, a clinical pharmacist was assigned to the ED in a 475-bed, tertiary care teaching facility that serves as a level I trauma center. On the arrival of a patient, ED providers completed a standard assessment that included the patient’s medication history. Patients to be admitted through the ED were interviewed by the clinical pharmacist. In addition to a medication history, the pharmacist collected the patient’s height, weight, immunization history, and allergy information. The medication history obtained by the ED provider was compared with the history obtained by the clinical pharmacist, and discrepancies were documented.

Results. The clinical pharmacists in the ED performed 286 medication histories; 34 were excluded. The remaining 252 histories taken were used in the study. The pharmacists identified 1096 home medications versus 817 home medications documented by ED providers. Of the 817 home medications documented by the ED, the regimens of 637 (78%) were incomplete and were supplemented with dosing information by the pharmacists. Pharmacists reported 375 medication allergies versus 350 reported by ED providers. Immunization histories were obtained in 252 of the 252 (100%) pharmacist-acquired medication histories versus 45 of the 252 (18%) acquired by ED personnel.

Conclusion. Pharmacist-acquired medication histories in the ED were more complete than those acquired by other health professionals.

Index terms: Clinical pharmacists; Clinical pharmacy; Health professions; Hospitals; Patient information; Pharmaceutical services

 





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