title: The accuracy of self-reported drug ingestion histories in emergency department patients.
abstract: Inaccuracies in self-reports may lead to duplication of therapy, failure to appreciate non-compliance leading to exacerbation of chronic medical conditions, or inaccurate research conclusions. Our objective is to determine the accuracy of self-reported drug ingestion histories in patients presenting to an urban academic emergency department (ED). We conducted a prospective cohort study in ED patients presenting for pain or nausea. We obtained a structured drug ingestion history including all prescription drugs, over-the-counter medication (OTC) drugs, and illicit drugs for the 48 hours prior to ED presentation. We obtained urine comprehensive drug screens (CDS) and determined self-report/CDS concordance. Fifty-five patients were enrolled. Self-reported drug ingestion histories were poor in these patients; only 17 (30.9%) of histories were concordant with the CDS. For the individual drug classes, prescription drug-CDS was concordant in 32 (58.2%), OTC-CDS was concordant in 33 (60%), and illicit drug-CDS was concordant in 45 (81.8%) of subjects. No demographic factors predicted an accurate self-reported drug history. Sixteen patients had drugs detected by CDS that were unreported by history. Nine of these 16 included an unreported opioid. In conclusion, self-reported drug ingestion histories are often inaccurate and resources are needed to confirm compliance and ensure unreported drugs are not overlooked.
authors: University of Colorado Department of Emergency Medicine, Aurora, CO, USA; Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA; Rocky Mountain Poison & Drug Center, Denver, Colorado, USA.
authors: Andrew A
authors: AA
authors: Monte
authors: Kennon J
authors: KJ
authors: Heard
authors: Jason A
authors: JA
authors: Hoppe
authors: Vasilis
authors: V
authors: Vasiliou
authors: Frank J
authors: FJ
authors: Gonzalez
mesh_terms: D000328:Adult; D004363:Drug Utilization / Q000706:statistics & numerical data*; D004435:Eating; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D013287:Illicit Drugs / Q000652:urine; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000008:administration & dosage; D055553:Prescription Drugs / Q000008:administration & dosage; D011446:Prospective Studies; D057566:Self Report; D015813:Substance Abuse Detection
chemical_list: D013287:Illicit Drugs; D004366:Nonprescription Drugs; D055553:Prescription Drugs
keywords: compliance; comprehensive urine toxicology screen; medication reconciliation; opioid abuse