title: Pharmacist- versus physician-acquired medication history: a prospective study at the emergency department.
abstract: BACKGROUND
  Recent literature revealed that medication histories obtained by physicians and nurses are often incomplete. However, the number of patients included was often low. Study objective In this study, the authors compare medication histories obtained in the Emergency Department (ED) by pharmacists versus physicians and identify characteristics contributing to discrepancies.
  
  
  METHODS
  Medication histories were acquired by the pharmacist from patients admitted to the ED, planned to be hospitalised. A structured form was used to guide the pharmacist or technician to ensure a standardised approach. Discrepancies, defined as any difference between the pharmacist-acquired medication history and that obtained by the physician, were analysed.
  
  
  RESULTS
  3594 medication histories were acquired by pharmacy staff. 59% (95% CI 58.2% to 59.8%) of medication histories recorded by physicians were different from those obtained by the pharmacy staff. Within these inaccurate medication histories, 5963 discrepancies were identified. The most common type of error was omission of a drug (61%; 95% CI 60.4% to 61.6%), followed by omission of dose (18%; 95% CI 17.6% to 18.4%). Drugs belonging to the class of psycholeptics, acid suppressors and beta blocking agents were related to the highest discrepancy rate. Acetylsalicylic acid, omeprazole and zolpidem were most commonly forgotten.
  
  
  CONCLUSIONS
  This large prospective study demonstrates that medication history acquisition is very often incomplete in the ED. A structured form and a standardised method is necessary. Pharmacists are especially suited to acquire and supervise accurate medication histories, as they are educated and familiar with commonly used drugs.
authors.affiliation: Pharmacy Department, University Hospitals Leuven, Leuven, Belgium. sabrina.dewinter@uzleuven.be
authors.forename: Sabrina
authors.initials: S
authors.lastname: De Winter
authors.forename: Isabel
authors.initials: I
authors.lastname: Spriet
authors.forename: Christophe
authors.initials: C
authors.lastname: Indevuyst
authors.forename: Peter
authors.initials: P
authors.lastname: Vanbrabant
authors.forename: Didier
authors.initials: D
authors.lastname: Desruelles
authors.forename: Marc
authors.initials: M
authors.lastname: Sabbe
authors.forename: Jean Bernard
authors.initials: JB
authors.lastname: Gillet
authors.forename: Alexander
authors.initials: A
authors.lastname: Wilmer
authors.forename: Ludo
authors.initials: L
authors.lastname: Willems
mesh_terms: D001530:Belgium; D004636:Emergency Service, Hospital; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008487:Medical History Taking; D059065:Medication Reconciliation / Q000592:standards*; D010595:Pharmacists; D010820:Physicians; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies