A medication history is a detailed, accurate, and complete account of all prescribed and non-prescribed medications that a patient had taken or is currently taking before a newly initiated institutionalized or ambulatory care. It provides valuable insights into patients’ allergic tendencies, adherence to pharmacological and non-pharmacological treatments, social drug use, and probable self-medication with complementary and alternative medicines. Availability of a detailed medication history, particularly at the prescribing stage of the medication use process, is critical to the success of the diagnostic and patient management tasks. This is because the occurrence of medication errors is strongly associated with inadequate or incomplete medication history.
The documentation of medication history has
historically been undertaken mainly by physicians and sometimes nurses.
However, several studies which were done primarily in developed setting showed that the medication
history information documented by physicians are often inaccurate, and incomplete; and lack information
regarding medication allergies, past
prescription /non-prescription medications, and patient’s adherence to prescribed doses.
The participation of pharmacists in the documentation
of medication history has been shown to
result in significant improvement in its accuracy and comprehensiveness. Pharmacists-acquired medication histories are
often free of the error of commission, and omission and more frequently document past prescription/ OTC medicines, allergy
history, and use of alcohol. However,
this concept has been tested only in developed countries. There is no published information on the impact of
pharmacists’ participation in the documentation of medication history in developing countries.
Like other developing countries, is beset with a poorly organized drug distribution system, poorly controlled access to orthodox and herbal medicines,
distribution and sale of counterfeit medicines, and pervasive self-medication
with prescription-only, over-the-counter, and herbal medicines.
Goals of Patient Medication History Interview:
The goal of a medication history interview is to
obtain information on aspects of drug use that may assist in the overall care of the patient. The information gathered
can be utilized to:
• Compare medication profiles with the medication
administration record and investigate
the discrepancies.
• Verify medication history taken by other staff and
provide additional information where
appropriate.
• Document allergies and adverse reactions.
• Screen for drug interactions.
• Assess patient medication compliance.
• Assess the rationale for a drug prescribed.
• Assess the evidence of drug abuse.
• Appraise the drug administration techniques.
• Examine the need for medication aids.
• Document patient-initiated medication
administration.
Importance of accurate medication history:
• Medication histories are important in preventing prescription errors and consequent risks to patients.
• Apart from preventing prescription errors, accurate
medication histories are also useful in
detecting drug-related pathology or changes in clinical signs that may be the result of drug therapy.
• A good medication history should encompass all
currently and recently prescribed drugs, previous adverse drug reactions
including hypersensitivity reactions, any over-the-counter medications,
including herbal or alternative medicines, and adherence to therapy for a
better health care plan.
• An entire medication history identifies patients’ needs
and explores the patient’s perspective of illness and its treatment (needs and
concerns).